CMS Formulary

Displaying 127361-127370 of 1611142 results.
ID: 127361
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127362
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127363
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127364
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127365
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 127366
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127367
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127368
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314075
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127369
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310812
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127370
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0