CMS Formulary

Displaying 127741-127750 of 1611142 results.
ID: 127741
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127742
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127743
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127744
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127745
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127746
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127747
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127748
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127749
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127750
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0