CMS Formulary

Displaying 126531-126540 of 1611142 results.
ID: 126531
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126532
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126533
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126534
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 126535
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126536
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126537
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126538
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126539
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126540
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30