CMS Formulary

Displaying 129631-129640 of 1611142 results.
ID: 129631
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129632
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129633
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129634
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129635
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129636
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129637
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129638
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129639
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129640
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0