CMS Formulary

Displaying 127121-127130 of 1611142 results.
ID: 127121
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127122
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127123
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127124
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127125
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127126
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127127
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127128
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127129
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127130
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855863
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0