CMS Formulary

Displaying 126911-126920 of 1611142 results.
ID: 126911
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126912
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126913
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126914
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1550940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126915
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126916
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126917
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126918
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126919
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126920
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0