CMS Formulary

Displaying 125481-125490 of 1611142 results.
ID: 125481
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1544475
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125482
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125483
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1747697
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125484
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1741739
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125485
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799218
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 125486
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2288816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 125487
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125488
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125489
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125490
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0