CMS Formulary

Displaying 126141-126150 of 1611142 results.
ID: 126141
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126142
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126143
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126144
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126145
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 126146
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126147
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126148
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313453
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126149
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 359050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126150
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30