CMS Formulary

Displaying 127521-127530 of 1611142 results.
ID: 127521
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403923
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 127522
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198322
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127523
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991039
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127524
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127525
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127526
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127527
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127528
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127529
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127530
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0