CMS Formulary

Displaying 124871-124880 of 1611142 results.
ID: 124871
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606866
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124872
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606870
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124873
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053519
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 124874
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2166401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124875
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812470
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 124876
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1655934
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 112
Qty Limit Days: 28
ID: 124877
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053512
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 124878
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124879
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 284592
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124880
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 284594
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0