CMS Formulary

Displaying 126941-126950 of 1611142 results.
ID: 126941
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126942
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126943
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126944
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126945
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126946
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126947
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126948
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126949
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 859088
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126950
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1539893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30