CMS Formulary

Displaying 125651-125660 of 1611142 results.
ID: 125651
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125652
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876673
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125653
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1876674
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125654
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1812434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125655
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125656
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125657
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125658
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373493
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125659
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125660
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1040058
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30