CMS Formulary

Displaying 124831-124840 of 1611142 results.
ID: 124831
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114202
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 124832
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 51
Qty Limit Days: 30
ID: 124833
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650968
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124834
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650972
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124835
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650974
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124836
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650976
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124837
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739766
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124838
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124839
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2173500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 124840
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1739778
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30