CMS Formulary

Displaying 129661-129670 of 1611142 results.
ID: 129661
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595478
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129662
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595292
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129663
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1995479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129664
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1595457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129665
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 153579
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129666
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 153580
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129667
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 129668
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129669
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129670
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30