CMS Formulary

Displaying 126311-126320 of 1611142 results.
ID: 126311
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126312
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126313
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2099323
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126314
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126315
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126316
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126317
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126318
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126319
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126320
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30