CMS Formulary

Displaying 125191-125200 of 1611142 results.
ID: 125191
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310531
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125192
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310535
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125193
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110618
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125194
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114074
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125195
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114096
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125196
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1114470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125197
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544404
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125198
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125199
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544386
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125200
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0