CMS Formulary

Displaying 125601-125610 of 1611142 results.
ID: 125601
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313165
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 6
Qty Limit Days: 30
ID: 125602
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125603
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807513
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125604
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125605
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313416
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125606
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 597823
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125607
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1726214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125608
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721458
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125609
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721460
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125610
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1726204
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0