CMS Formulary

Displaying 126991-127000 of 1611142 results.
ID: 126991
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 993462
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126992
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1867547
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126993
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 126994
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 608934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126995
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126996
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126997
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126998
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126999
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 127000
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0