CMS Formulary

Displaying 124371-124380 of 1611142 results.
ID: 124371
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124372
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124373
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124374
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124375
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124376
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124377
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124378
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124379
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124380
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0