CMS Formulary

Displaying 127551-127560 of 1611142 results.
ID: 127551
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 854252
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127552
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 406503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127553
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858262
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127554
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127555
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 403890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127556
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197549
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127557
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127558
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127559
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127560
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30