CMS Formulary

Displaying 127581-127590 of 1611142 results.
ID: 127581
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127582
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127583
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127584
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127585
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127586
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127587
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127588
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127589
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 899548
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127590
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863664
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0