CMS Formulary

Displaying 124041-124050 of 1611142 results.
ID: 124041
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124042
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 124043
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309339
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124044
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124045
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124046
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308207
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124047
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721475
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124048
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 789980
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124049
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 545835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124050
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 754508
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0