CMS Formulary

Displaying 125011-125020 of 1611142 results.
ID: 125011
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125012
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125013
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125014
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716215
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125015
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716219
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125016
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125017
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125018
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 852920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125019
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313096
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125020
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198224
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0