CMS Formulary

Displaying 124781-124790 of 1611142 results.
ID: 124781
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1727485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 124782
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441530
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124783
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124784
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2106075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124785
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058950
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124786
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058946
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124787
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124788
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 124789
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 124790
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2054310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30