CMS Formulary

Displaying 125671-125680 of 1611142 results.
ID: 125671
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 125672
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600774
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125673
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125674
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600915
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125675
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1600917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125676
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1117531
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125677
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125678
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125679
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125680
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0