CMS Formulary

Displaying 126201-126210 of 1611142 results.
ID: 126201
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1731020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126202
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126203
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1944656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126204
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126205
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126206
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126207
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 728113
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126208
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126209
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483448
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126210
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483446
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30