CMS Formulary

Displaying 126011-126020 of 1611142 results.
ID: 126011
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1422081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126012
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1427300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126013
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126014
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727521
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126015
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1873704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126016
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848180
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126017
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197573
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 126018
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123072
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126019
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314076
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126020
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314077
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30