CMS Formulary

Displaying 124351-124360 of 1611142 results.
ID: 124351
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124352
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124353
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124354
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124355
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124356
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124357
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124358
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1149376
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124359
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124360
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0