CMS Formulary

Displaying 127311-127320 of 1611142 results.
ID: 127311
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000135
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127312
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127313
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127314
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127315
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127316
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127317
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127318
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127319
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127320
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0