CMS Formulary

Displaying 126151-126160 of 1611142 results.
ID: 126151
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 126152
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 126153
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126154
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126155
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126156
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126157
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126158
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126159
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126160
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0