CMS Formulary

Displaying 127891-127900 of 1611142 results.
ID: 127891
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127892
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 158
Qty Limit Days: 30
ID: 127893
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 127894
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 465355
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127895
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 979099
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127896
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 967023
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127897
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 967012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127898
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127899
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311989
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127900
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0