CMS Formulary

Displaying 124561-124570 of 1611142 results.
ID: 124561
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649996
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 124562
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650004
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 28
ID: 124563
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2477272
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124564
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 795749
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 124565
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1809520
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124566
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 239189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124567
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124568
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309072
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124569
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124570
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0