CMS Formulary

Displaying 124681-124690 of 1611142 results.
ID: 124681
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124682
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124683
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124684
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 124685
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124686
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124687
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796079
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124688
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796083
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124689
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124690
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1546894
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30