CMS Formulary

Displaying 126031-126040 of 1611142 results.
ID: 126031
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126032
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126033
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126034
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126035
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126036
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126037
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 126038
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126039
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126040
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0