CMS Formulary

Displaying 127331-127340 of 1611142 results.
ID: 127331
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127332
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127333
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127334
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127335
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127336
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127337
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127338
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 753482
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127339
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 750268
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127340
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 761977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0