CMS Formulary

Displaying 129591-129600 of 1611142 results.
ID: 129591
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129592
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 607579
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129593
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1145932
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129594
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129595
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129596
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129597
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 129598
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129599
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129600
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0