CMS Formulary

Displaying 125781-125790 of 1611142 results.
ID: 125781
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125782
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125783
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125784
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125785
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125786
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125787
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125788
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 125789
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125790
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30