CMS Formulary

Displaying 126181-126190 of 1611142 results.
ID: 126181
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126182
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 126183
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 126184
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126185
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126186
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126187
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 432402
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126188
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477560
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126189
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477562
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126190
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373497
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0