CMS Formulary

Displaying 127081-127090 of 1611142 results.
ID: 127081
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 615107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127082
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 615111
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127083
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 847626
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127084
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312128
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127085
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 240637
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127086
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 801405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127087
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127088
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 127089
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127090
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0