CMS Formulary

Displaying 129681-129690 of 1611142 results.
ID: 129681
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129682
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129683
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129684
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129685
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129686
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129687
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 129688
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129689
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129690
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0