CMS Formulary

Displaying 125581-125590 of 1611142 results.
ID: 125581
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1604352
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125582
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 212118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 125583
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 542370
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 125584
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988768
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125585
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 125586
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125587
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1988786
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125588
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723763
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 125589
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723767
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 125590
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723772
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28