CMS Formulary

Displaying 125551-125560 of 1611142 results.
ID: 125551
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860975
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 125552
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860981
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125553
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312136
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125554
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312137
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125555
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299911
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125556
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125557
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125558
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855873
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125559
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125560
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308988
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0