CMS Formulary

Displaying 127661-127670 of 1611142 results.
ID: 127661
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127662
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 317573
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127663
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312440
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127664
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312441
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127665
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127666
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127667
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127668
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127669
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127670
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0