CMS Formulary

Displaying 124981-124990 of 1611142 results.
ID: 124981
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124982
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124983
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 124984
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124985
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124986
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124987
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124988
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124989
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124990
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0