CMS Formulary

Displaying 127301-127310 of 1611142 results.
ID: 127301
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127302
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127303
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127304
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127305
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127306
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127307
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127308
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577957
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127309
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127310
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0