CMS Formulary

Displaying 129311-129320 of 1611142 results.
ID: 129311
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129312
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129313
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129314
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129315
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129316
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129317
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129318
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129319
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129320
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0