CMS Formulary

Displaying 125061-125070 of 1611142 results.
ID: 125061
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199655
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125062
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349208
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125063
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 360110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125064
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125065
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206917
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125066
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1657151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 125067
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125068
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659592
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125069
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125070
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 240984
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0