CMS Formulary

Displaying 124191-124200 of 1611142 results.
ID: 124191
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124192
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124193
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124194
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124195
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124196
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124197
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124198
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124199
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124200
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0