CMS Formulary

Displaying 125841-125850 of 1611142 results.
ID: 125841
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125842
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 125843
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125844
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125845
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125846
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242120
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125847
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125848
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 628958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125849
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125850
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30