CMS Formulary

Displaying 129651-129660 of 1611142 results.
ID: 129651
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129652
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129653
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129654
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129655
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129656
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000089
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129657
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190955
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129658
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190957
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129659
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129660
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595473
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0