CMS Formulary

Displaying 124341-124350 of 1611142 results.
ID: 124341
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124342
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310594
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124343
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 754512
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124344
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905379
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124345
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 686405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124346
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 863603
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124347
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124348
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124349
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124350
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30