CMS Formulary

Displaying 127141-127150 of 1611142 results.
ID: 127141
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 359145
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127142
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000076
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127143
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127144
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127145
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127146
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127147
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127148
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127149
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127150
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0