CMS Formulary

Displaying 127421-127430 of 1611142 results.
ID: 127421
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127422
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127423
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 127424
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127425
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 127426
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127427
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127428
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127429
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127430
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30