CMS Formulary

Displaying 127071-127080 of 1611142 results.
ID: 127071
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 630796
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127072
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1863605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127073
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 615099
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127074
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 615100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127075
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127076
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 637551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127077
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 237367
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127078
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1860463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127079
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1860239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127080
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0