CMS Formulary

Displaying 126821-126830 of 1611142 results.
ID: 126821
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126822
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126823
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1918209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 126824
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1918194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 126825
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1918203
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 126826
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126827
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126828
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126829
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126830
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0