CMS Formulary

Displaying 127201-127210 of 1611142 results.
ID: 127201
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 127202
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 127203
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 127204
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127205
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127206
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127207
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127208
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127209
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127210
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0