CMS Formulary

Displaying 129521-129530 of 1611142 results.
ID: 129521
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905059
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129522
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905064
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129523
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905057
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129524
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129525
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129526
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129527
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 525
Qty Limit Days: 30
ID: 129528
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129529
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129530
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0