CMS Formulary

Displaying 124261-124270 of 1611142 results.
ID: 124261
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124262
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124263
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124264
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124265
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124266
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124267
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124268
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124269
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124270
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0