CMS Formulary

Displaying 124501-124510 of 1611142 results.
ID: 124501
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124502
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124503
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124504
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124505
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124506
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124507
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848752
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124508
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1491624
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124509
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468316
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 158
Qty Limit Days: 30
ID: 124510
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2381144
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30