CMS Formulary

Displaying 125231-125240 of 1611142 results.
ID: 125231
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1871459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125232
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1871469
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125233
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1871467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125234
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125235
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125236
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125237
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125238
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125239
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125240
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616114
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30