CMS Formulary

Displaying 126041-126050 of 1611142 results.
ID: 126041
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126042
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126043
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126044
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126045
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126046
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126047
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126048
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126049
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126050
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30