CMS Formulary

Displaying 126961-126970 of 1611142 results.
ID: 126961
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126962
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126963
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126964
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126965
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126966
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126967
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126968
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126969
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 126970
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30