CMS Formulary

Displaying 125691-125700 of 1611142 results.
ID: 125691
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125692
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125693
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125694
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 125695
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125696
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125697
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125698
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125699
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125700
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0