CMS Formulary

Displaying 124411-124420 of 1611142 results.
ID: 124411
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124412
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124413
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124414
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124415
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124416
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124417
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124418
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124419
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124420
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0