CMS Formulary

Displaying 127681-127690 of 1611142 results.
ID: 127681
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127682
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127683
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127684
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127685
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127686
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127687
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127688
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127689
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127690
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0