CMS Formulary

Displaying 127831-127840 of 1611142 results.
ID: 127831
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127832
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127833
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127834
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127835
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127836
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127837
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127838
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127839
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127840
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30