CMS Formulary

Displaying 124241-124250 of 1611142 results.
ID: 124241
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197956
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124242
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124243
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200064
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124244
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124245
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124246
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124247
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124248
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124249
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124250
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30