CMS Formulary

Displaying 124061-124070 of 1611142 results.
ID: 124061
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124062
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476576
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124063
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 617423
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124064
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 617993
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124065
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 745302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124066
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 124067
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 142046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124068
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 244374
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124069
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 238004
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 124070
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313921
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0