CMS Formulary

Displaying 124131-124140 of 1611142 results.
ID: 124131
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124132
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124133
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 801054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124134
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124135
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124136
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124137
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124138
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124139
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310992
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124140
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30