CMS Formulary

Displaying 126081-126090 of 1611142 results.
ID: 126081
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126082
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126083
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126084
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126085
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126086
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126087
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311753
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126088
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299897
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126089
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126090
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0