CMS Formulary

Displaying 125751-125760 of 1611142 results.
ID: 125751
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125752
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125753
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125754
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125755
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125756
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125757
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125758
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125759
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125760
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30