CMS Formulary

Displaying 124961-124970 of 1611142 results.
ID: 124961
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124962
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124963
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124964
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124965
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359134
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124966
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312138
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124967
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 124968
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 124969
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359127
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124970
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30