CMS Formulary

Displaying 124811-124820 of 1611142 results.
ID: 124811
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 124812
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124813
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 124814
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 124815
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124816
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124817
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207059
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 124818
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 211140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124819
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 706831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124820
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 706827
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0