CMS Formulary

Displaying 129791-129800 of 1611142 results.
ID: 129791
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102440
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129792
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 129793
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129794
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129795
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058926
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129796
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102460
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129797
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047602
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129798
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129799
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047614
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129800
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047596
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0