CMS Formulary

Displaying 124641-124650 of 1611142 results.
ID: 124641
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124642
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124643
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124644
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124645
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124646
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124647
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 903847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124648
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307061
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124649
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1115698
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 780
Qty Limit Days: 30
ID: 124650
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1308569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30