CMS Formulary

Displaying 127171-127180 of 1611142 results.
ID: 127171
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1607990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127172
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127173
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127174
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 209789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127175
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 209788
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127176
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127177
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127178
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127179
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127180
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577057
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30