CMS Formulary

Displaying 129871-129880 of 1611142 results.
ID: 129871
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 129872
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 129873
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129874
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129875
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129876
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129877
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129878
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129879
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129880
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0