CMS Formulary

Displaying 129721-129730 of 1611142 results.
ID: 129721
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129722
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129723
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129724
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129725
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129726
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129727
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129728
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129729
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129730
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30