CMS Formulary

Displaying 126471-126480 of 1611142 results.
ID: 126471
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126472
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126473
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126474
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126475
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126476
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126477
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126478
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126479
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126480
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30