CMS Formulary

Displaying 124431-124440 of 1611142 results.
ID: 124431
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197313
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124432
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313566
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124433
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124434
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124435
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859424
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124436
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859747
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124437
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124438
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124439
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124440
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30