CMS Formulary

Displaying 129541-129550 of 1611142 results.
ID: 129541
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129542
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129543
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129544
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 208560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129545
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1992305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129546
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129547
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129548
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129549
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861663
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129550
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 545278
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0