CMS Formulary

Displaying 127861-127870 of 1611142 results.
ID: 127861
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127862
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127863
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127864
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127865
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127866
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127867
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127868
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127869
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127870
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0