CMS Formulary

Displaying 129801-129810 of 1611142 results.
ID: 129801
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047623
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129802
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2463737
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129803
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102464
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129804
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2463733
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129805
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129806
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129807
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129808
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 129809
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129810
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0