CMS Formulary

Displaying 129421-129430 of 1611142 results.
ID: 129421
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809416
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129422
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129423
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129424
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129425
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129426
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129427
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129428
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129429
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2049121
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129430
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1365979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0