CMS Formulary

Displaying 129621-129630 of 1611142 results.
ID: 129621
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 129622
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 129623
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 129624
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 129625
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 129626
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 129627
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 129628
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 129629
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 129630
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1