CMS Formulary

Displaying 124471-124480 of 1611142 results.
ID: 124471
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790171
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124472
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197703
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124473
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300783
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 124474
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 831261
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124475
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 825005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 124476
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124477
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 984105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124478
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197417
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124479
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197418
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124480
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197419
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0