CMS Formulary

Displaying 124201-124210 of 1611142 results.
ID: 124201
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124202
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124203
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124204
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124205
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124206
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 124207
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 615882
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124208
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 643070
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124209
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 797697
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124210
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855926
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0