CMS Formulary

Displaying 127611-127620 of 1611142 results.
ID: 127611
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127612
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127613
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127614
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127615
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127616
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127617
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127618
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127619
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127620
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30