CMS Formulary

Displaying 127411-127420 of 1611142 results.
ID: 127411
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127412
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127413
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127414
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1100706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127415
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1430449
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127416
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1592748
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127417
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1592752
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127418
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1243033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127419
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1243040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127420
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30