CMS Formulary

Displaying 126441-126450 of 1611142 results.
ID: 126441
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126442
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126443
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126444
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126445
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126446
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 126447
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126448
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126449
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126450
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1547114
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30