CMS Formulary

Displaying 127341-127350 of 1611142 results.
ID: 127341
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 750265
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127342
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 762001
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127343
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 762334
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127344
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 753483
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127345
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 750267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127346
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 801185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127347
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898362
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127348
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127349
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127350
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0