CMS Formulary

Displaying 124541-124550 of 1611142 results.
ID: 124541
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124542
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124543
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124544
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124545
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124546
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124547
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124548
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124549
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124550
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0