CMS Formulary

Displaying 126851-126860 of 1611142 results.
ID: 126851
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1876397
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126852
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1235267
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126853
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 349094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126854
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351109
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126855
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1098666
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126856
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126857
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126858
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126859
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 126860
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0