CMS Formulary

Displaying 124161-124170 of 1611142 results.
ID: 124161
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124162
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124163
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124164
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124165
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 124166
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 124167
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 124168
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124169
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124170
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0