CMS Formulary

Displaying 127921-127930 of 1611142 results.
ID: 127921
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127922
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127923
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127924
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127925
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127926
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 127927
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127928
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 127929
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127930
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0