CMS Formulary

Displaying 125811-125820 of 1611142 results.
ID: 125811
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125812
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860695
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125813
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860707
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125814
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125815
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 419849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125816
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125817
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125818
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125819
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125820
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30