CMS Formulary

Displaying 129371-129380 of 1611142 results.
ID: 129371
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310459
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129372
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 828320
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129373
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129374
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129375
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1731020
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129376
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129377
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1944656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129378
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129379
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129380
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0