CMS Formulary

Displaying 127451-127460 of 1611142 results.
ID: 127451
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127452
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127453
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127454
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127455
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127456
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1993222
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127457
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 430551
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127458
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403920
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127459
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312068
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127460
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0