CMS Formulary

Displaying 126591-126600 of 1611142 results.
ID: 126591
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126592
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126593
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126594
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126595
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126596
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126597
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126598
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126599
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126600
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0