CMS Formulary

Displaying 127051-127060 of 1611142 results.
ID: 127051
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127052
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127053
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127054
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127055
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127056
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127057
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127058
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1794886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127059
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1795346
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127060
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 801357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0