CMS Formulary

Displaying 126271-126280 of 1611142 results.
ID: 126271
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1720616
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126272
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126273
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126274
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126275
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126276
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126277
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126278
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126279
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126280
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0