CMS Formulary

Displaying 129271-129280 of 1611142 results.
ID: 129271
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129272
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 129273
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 129274
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 129275
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 129276
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129277
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129278
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129279
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129280
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0