CMS Formulary

Displaying 127811-127820 of 1611142 results.
ID: 127811
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127812
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127813
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127814
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127815
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127816
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127817
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127818
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127819
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127820
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30