CMS Formulary

Displaying 126211-126220 of 1611142 results.
ID: 126211
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126212
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310155
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126213
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 315090
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126214
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126215
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126216
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1366192
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 126217
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126218
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126219
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126220
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30