CMS Formulary

Displaying 124721-124730 of 1611142 results.
ID: 124721
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124722
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124723
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351276
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124724
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124725
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124726
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124727
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124728
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124729
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124730
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30