CMS Formulary

Displaying 127651-127660 of 1611142 results.
ID: 127651
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127652
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127653
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127654
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127655
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 127656
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127657
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127658
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127659
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127660
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30