CMS Formulary

Displaying 124771-124780 of 1611142 results.
ID: 124771
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124772
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477372
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124773
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124774
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 124775
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 124776
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124777
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205532
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 124778
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1592285
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 124779
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 124780
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1868020
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30