CMS Formulary

Displaying 126111-126120 of 1611142 results.
ID: 126111
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126112
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126113
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126114
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126115
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126116
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126117
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126118
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126119
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126120
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0