CMS Formulary

Displaying 124691-124700 of 1611142 results.
ID: 124691
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857913
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124692
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857917
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124693
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1857925
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1840
Qty Limit Days: 30
ID: 124694
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989506
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124695
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2122526
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124696
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2380551
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124697
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124698
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124699
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124700
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0