CMS Formulary

Displaying 129561-129570 of 1611142 results.
ID: 129561
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129562
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 865098
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129563
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129564
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129565
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129566
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129567
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129568
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129569
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129570
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0