CMS Formulary

Displaying 124441-124450 of 1611142 results.
ID: 124441
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124442
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124443
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124444
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124445
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124446
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124447
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124448
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124449
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124450
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30