CMS Formulary

Displaying 125821-125830 of 1611142 results.
ID: 125821
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125822
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125823
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125824
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125825
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125826
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125827
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861375
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125828
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861370
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125829
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125830
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922783
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0