CMS Formulary

Displaying 127671-127680 of 1611142 results.
ID: 127671
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127672
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127673
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127674
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127675
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127676
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127677
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127678
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127679
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 127680
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30