CMS Formulary

Displaying 126981-126990 of 1611142 results.
ID: 126981
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126982
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126983
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197816
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126984
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197815
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126985
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1001004
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126986
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 351264
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 126987
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 848951
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126988
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 834346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126989
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993466
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126990
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993470
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0