CMS Formulary

Displaying 129911-129920 of 1611142 results.
ID: 129911
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 129912
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 129913
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 129914
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 129915
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129916
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129917
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129918
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 129919
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 129920
Formulary ID: 00021054
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0