CMS Formulary

Displaying 126051-126060 of 1611142 results.
ID: 126051
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126052
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126053
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126054
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 359500
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126055
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126056
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126057
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836395
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 126058
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198116
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126059
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349253
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126060
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 656659
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30