CMS Formulary

Displaying 124521-124530 of 1611142 results.
ID: 124521
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124522
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124523
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124524
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300272
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 124525
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124526
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124527
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124528
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124529
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124530
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30