CMS Formulary

Displaying 129501-129510 of 1611142 results.
ID: 129501
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966177
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129502
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129503
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966187
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129504
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2104866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129505
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129506
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129507
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129508
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 129509
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 129510
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28