CMS Formulary

Displaying 124291-124300 of 1611142 results.
ID: 124291
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124292
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124293
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124294
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124295
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 124296
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 124297
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897722
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124298
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197942
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124299
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197941
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124300
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861007
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30