CMS Formulary

Displaying 126231-126240 of 1611142 results.
ID: 126231
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099681
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126232
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197682
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126233
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866910
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126234
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308867
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126235
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126236
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1092357
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126237
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 126238
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 126239
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 126240
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0