CMS Formulary

Displaying 127761-127770 of 1611142 results.
ID: 127761
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127762
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127763
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127764
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127765
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127766
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127767
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127768
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127769
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127770
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0