CMS Formulary

Displaying 127561-127570 of 1611142 results.
ID: 127561
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127562
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127563
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127564
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127565
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127566
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127567
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127568
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127569
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127570
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1946529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30