CMS Formulary

Displaying 126241-126250 of 1611142 results.
ID: 126241
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1867544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126242
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126243
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126244
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 126245
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126246
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126247
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126248
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126249
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809416
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126250
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0