CMS Formulary

Displaying 127911-127920 of 1611142 results.
ID: 127911
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127912
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127913
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127914
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127915
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127916
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127917
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127918
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127919
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127920
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30