CMS Formulary

Displaying 126361-126370 of 1611142 results.
ID: 126361
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198050
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126362
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198049
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126363
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251334
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126364
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1368459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 525
Qty Limit Days: 30
ID: 126365
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751970
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126366
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284516
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126367
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2284514
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126368
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126369
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126370
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0