CMS Formulary

Displaying 125521-125530 of 1611142 results.
ID: 125521
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125522
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125523
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125524
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125525
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125526
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125527
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125528
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125529
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125530
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30