CMS Formulary

Displaying 126811-126820 of 1611142 results.
ID: 126811
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126812
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126813
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126814
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126815
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126816
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126817
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126818
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126819
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126820
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0