CMS Formulary

Displaying 127851-127860 of 1611142 results.
ID: 127851
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127852
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127853
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127854
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1363410
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127855
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1364581
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127856
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127857
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790167
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127858
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127859
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127860
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1