CMS Formulary

Displaying 127381-127390 of 1611142 results.
ID: 127381
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127382
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127383
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127384
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127385
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127386
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127387
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127388
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127389
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127390
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0