CMS Formulary

Displaying 126371-126380 of 1611142 results.
ID: 126371
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126372
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126373
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126374
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126375
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126376
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126377
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126378
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126379
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126380
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0