CMS Formulary

Displaying 127031-127040 of 1611142 results.
ID: 127031
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127032
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127033
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127034
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127035
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127036
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127037
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790644
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 127038
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127039
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127040
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1043567
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30