CMS Formulary

Displaying 127881-127890 of 1611142 results.
ID: 127881
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 127882
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127883
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127884
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127885
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127886
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127887
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127888
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127889
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127890
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0