CMS Formulary

Displaying 125201-125210 of 1611142 results.
ID: 125201
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544390
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125202
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544394
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125203
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544396
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125204
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544398
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125205
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125206
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659818
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125207
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659814
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125208
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658325
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125209
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658329
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125210
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658333
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30