CMS Formulary

Displaying 127241-127250 of 1611142 results.
ID: 127241
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127242
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127243
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127244
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127245
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127246
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127247
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127248
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127249
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127250
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30