CMS Formulary

Displaying 125041-125050 of 1611142 results.
ID: 125041
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125042
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125043
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125044
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125045
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125046
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125047
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313413
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125048
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314286
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125049
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313776
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125050
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313777
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30