CMS Formulary

Displaying 124851-124860 of 1611142 results.
ID: 124851
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124852
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124853
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124854
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124855
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124856
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124857
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198035
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124858
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198036
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124859
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124860
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1193337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30