CMS Formulary

Displaying 127261-127270 of 1611142 results.
ID: 127261
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127262
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127263
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127264
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127265
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127266
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127267
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127268
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127269
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127270
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0