CMS Formulary

Displaying 127001-127010 of 1611142 results.
ID: 127001
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127002
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127003
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127004
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127005
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127006
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127007
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127008
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127009
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 999965
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127010
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0