CMS Formulary

Displaying 125541-125550 of 1611142 results.
ID: 125541
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 886662
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125542
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 886666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125543
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 886671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125544
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 686400
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125545
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125546
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476345
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125547
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476349
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125548
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476350
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125549
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476351
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125550
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0