CMS Formulary

Displaying 127041-127050 of 1611142 results.
ID: 127041
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127042
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127043
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127044
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1486977
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127045
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1940498
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127046
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1593831
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127047
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1593833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127048
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1593835
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127049
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1593775
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127050
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28