CMS Formulary

Displaying 126971-126980 of 1611142 results.
ID: 126971
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126972
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126973
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966524
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 126974
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 966529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 126975
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1539762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126976
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 126977
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126978
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126979
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 126980
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30