CMS Formulary

Displaying 124401-124410 of 1611142 results.
ID: 124401
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124402
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124403
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124404
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124405
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124406
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124407
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124408
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124409
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124410
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30