CMS Formulary

Displaying 127961-127970 of 1611142 results.
ID: 127961
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 127962
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127963
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127964
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127965
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127966
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127967
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127968
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127969
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127970
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0