CMS Formulary

Displaying 126071-126080 of 1611142 results.
ID: 126071
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126072
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126073
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988330
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126074
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126075
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 126076
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 126077
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 126078
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 126079
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126080
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0