CMS Formulary

Displaying 124111-124120 of 1611142 results.
ID: 124111
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197550
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124112
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102717
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124113
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124114
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2102715
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124115
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 348506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124116
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124117
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124118
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124119
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124120
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30