CMS Formulary

Displaying 127771-127780 of 1611142 results.
ID: 127771
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127772
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127773
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127774
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127775
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127776
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127777
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127778
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127779
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127780
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1372999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0