CMS Formulary

Displaying 127751-127760 of 1611142 results.
ID: 127751
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127752
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127753
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 754512
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127754
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127755
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863603
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127756
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127757
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127758
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127759
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127760
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30