CMS Formulary

Displaying 124671-124680 of 1611142 results.
ID: 124671
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124672
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124673
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124674
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 124675
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 124676
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 124677
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2001430
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124678
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124679
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2043464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124680
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30