CMS Formulary

Displaying 127221-127230 of 1611142 results.
ID: 127221
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127222
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127223
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665021
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127224
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127225
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127226
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127227
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127228
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127229
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127230
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30