CMS Formulary

Displaying 129321-129330 of 1611142 results.
ID: 129321
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129322
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129323
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129324
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129325
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129326
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129327
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129328
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 129329
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129330
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0