CMS Formulary

Displaying 124921-124930 of 1611142 results.
ID: 124921
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124922
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124923
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124924
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124925
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124926
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124927
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124928
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124929
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124930
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0