CMS Formulary

Displaying 124181-124190 of 1611142 results.
ID: 124181
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124182
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124183
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124184
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124185
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124186
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124187
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124188
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124189
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124190
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30