CMS Formulary

Displaying 125511-125520 of 1611142 results.
ID: 125511
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125512
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125513
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125514
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125515
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 125516
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125517
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125518
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125519
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125520
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30