CMS Formulary

Displaying 124251-124260 of 1611142 results.
ID: 124251
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124252
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124253
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124254
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124255
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124256
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124257
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124258
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 124259
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124260
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30