CMS Formulary

Displaying 126291-126300 of 1611142 results.
ID: 126291
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126292
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 126293
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 126294
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126295
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126296
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 126297
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 126298
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 126299
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126300
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1249631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0