CMS Formulary

Displaying 124451-124460 of 1611142 results.
ID: 124451
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124452
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124453
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124454
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124455
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124456
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124457
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124458
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124459
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124460
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30