CMS Formulary

Displaying 125031-125040 of 1611142 results.
ID: 125031
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125032
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125033
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125034
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 125035
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125036
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125037
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125038
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125039
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125040
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0