CMS Formulary

Displaying 127841-127850 of 1611142 results.
ID: 127841
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127842
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127843
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127844
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127845
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127846
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127847
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127848
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127849
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127850
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30