CMS Formulary

Displaying 129301-129310 of 1611142 results.
ID: 129301
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129302
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129303
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129304
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129305
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129306
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129307
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129308
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129309
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129310
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0