CMS Formulary

Displaying 124121-124130 of 1611142 results.
ID: 124121
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124122
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207249
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124123
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124124
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124125
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124126
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946527
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124127
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946525
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124128
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124129
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124130
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30