CMS Formulary

Displaying 125211-125220 of 1611142 results.
ID: 125211
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658337
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125212
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658341
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125213
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658345
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125214
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602604
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125215
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602607
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125216
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 104206
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125217
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309888
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125218
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309889
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125219
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 745752
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125220
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649961
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0