CMS Formulary

Displaying 124221-124230 of 1611142 results.
ID: 124221
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124222
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124223
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124224
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124225
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124226
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124227
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124228
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124229
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124230
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30