CMS Formulary

Displaying 127181-127190 of 1611142 results.
ID: 127181
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 127182
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127183
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127184
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127185
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127186
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 127187
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127188
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127189
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127190
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30