CMS Formulary

Displaying 127871-127880 of 1611142 results.
ID: 127871
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127872
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127873
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127874
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127875
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127876
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127877
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127878
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127879
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 127880
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30