CMS Formulary

Displaying 125991-126000 of 1611142 results.
ID: 125991
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125992
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125993
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125994
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125995
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125996
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125997
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 642452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125998
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 602635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125999
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126000
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736656
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0