CMS Formulary

Displaying 129751-129760 of 1611142 results.
ID: 129751
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129752
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129753
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129754
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 603978
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129755
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129756
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129757
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 208821
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129758
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 804547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129759
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 351875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129760
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30