CMS Formulary

Displaying 125161-125170 of 1611142 results.
ID: 125161
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000019
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125162
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1994362
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125163
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 125164
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000023
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125165
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000027
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125166
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000031
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125167
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539248
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125168
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300386
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 125169
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 829989
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 125170
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830552
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1