CMS Formulary

Displaying 127711-127720 of 1611142 results.
ID: 127711
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 127712
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 127713
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127714
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127715
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127716
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 127717
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861010
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127718
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861004
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 75
Qty Limit Days: 30
ID: 127719
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861731
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 127720
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 562524
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0