CMS Formulary

Displaying 129261-129270 of 1611142 results.
ID: 129261
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199376
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129262
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129263
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129264
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314142
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 129265
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 129266
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129267
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129268
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1988316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129269
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129270
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0