CMS Formulary

Displaying 127901-127910 of 1611142 results.
ID: 127901
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 127902
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127903
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127904
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127905
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127906
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127907
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127908
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127909
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127910
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0