CMS Formulary

Displaying 127591-127600 of 1611142 results.
ID: 127591
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1012017
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127592
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2055676
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127593
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2055672
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127594
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1010603
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127595
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1307058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127596
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1010606
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127597
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1307063
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127598
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127599
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 127600
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0