CMS Formulary

Displaying 124891-124900 of 1611142 results.
ID: 124891
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124892
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124893
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124894
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124895
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124896
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124897
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124898
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 124899
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124900
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0