CMS Formulary

Displaying 124651-124660 of 1611142 results.
ID: 124651
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351209
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124652
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124653
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197623
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124654
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1435115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 124655
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099808
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124656
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1484296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124657
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 124658
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244205
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 124659
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830470
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 124660
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1