CMS Formulary

Displaying 127971-127980 of 1611142 results.
ID: 127971
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597120
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127972
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597126
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127973
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 127974
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127975
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127976
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127977
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127978
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127979
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127980
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30