CMS Formulary

Displaying 127431-127440 of 1611142 results.
ID: 127431
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127432
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127433
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127434
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127435
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127436
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127437
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127438
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127439
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127440
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0