CMS Formulary

Displaying 124381-124390 of 1611142 results.
ID: 124381
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124382
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124383
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1372999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124384
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124385
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124386
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124387
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 282401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124388
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198427
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124389
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124390
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198429
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0