CMS Formulary

Displaying 124911-124920 of 1611142 results.
ID: 124911
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124912
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124913
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124914
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124915
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124916
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124917
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124918
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124919
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124920
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30