CMS Formulary

Displaying 124971-124980 of 1611142 results.
ID: 124971
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124972
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124973
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124974
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124975
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124976
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124977
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124978
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124979
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124980
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0