CMS Formulary

Displaying 124801-124810 of 1611142 results.
ID: 124801
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010739
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124802
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 391937
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124803
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197305
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124804
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313786
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124805
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1312408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124806
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439894
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124807
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124808
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124809
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124810
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0