CMS Formulary

Displaying 124421-124430 of 1611142 results.
ID: 124421
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124422
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124423
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124424
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124425
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124426
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124427
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200094
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124428
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200095
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124429
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200096
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124430
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197311
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0