CMS Formulary

Displaying 126461-126470 of 1611142 results.
ID: 126461
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 126462
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 126463
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 126464
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 126465
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126466
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126467
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126468
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 126469
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 126470
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1