CMS Formulary

Displaying 127391-127400 of 1611142 results.
ID: 127391
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127392
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127393
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 127394
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127395
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127396
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127397
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127398
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127399
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127400
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197366
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0