CMS Formulary

Displaying 125831-125840 of 1611142 results.
ID: 125831
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485442
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125832
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125833
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989085
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 224
Qty Limit Days: 28
ID: 125834
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 582595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 210
Qty Limit Days: 30
ID: 125835
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861966
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 125836
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1442143
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125837
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488667
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125838
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125839
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488675
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125840
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1488679
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0