CMS Formulary

Displaying 125341-125350 of 1611142 results.
ID: 125341
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125342
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125343
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125344
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125345
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125346
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125347
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125348
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125349
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 125350
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30