CMS Formulary

Displaying 126091-126100 of 1611142 results.
ID: 126091
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 151029
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126092
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311265
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126093
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311264
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126094
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897649
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126095
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349594
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126096
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349595
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126097
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126098
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126099
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126100
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0