CMS Formulary

Displaying 129401-129410 of 1611142 results.
ID: 129401
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310003
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129402
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129403
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129404
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129405
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129406
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129407
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129408
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129409
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 129410
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30