CMS Formulary

Displaying 124611-124620 of 1611142 results.
ID: 124611
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124612
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124613
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124614
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124615
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124616
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124617
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124618
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124619
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124620
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30