CMS Formulary

Displaying 124761-124770 of 1611142 results.
ID: 124761
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124762
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124763
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124764
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124765
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124766
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124767
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 124768
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 124769
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124770
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30