CMS Formulary

Displaying 127621-127630 of 1611142 results.
ID: 127621
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127622
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127623
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127624
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127625
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127626
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127627
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127628
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127629
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127630
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0