CMS Formulary

Displaying 126331-126340 of 1611142 results.
ID: 126331
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 126332
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966153
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126333
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966160
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126334
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966166
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126335
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966173
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126336
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966177
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126337
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126338
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966187
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126339
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2104866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126340
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0