CMS Formulary

Displaying 124591-124600 of 1611142 results.
ID: 124591
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124592
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124593
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124594
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124595
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124596
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124597
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597120
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124598
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597126
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124599
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 124600
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0