CMS Formulary

Displaying 125911-125920 of 1611142 results.
ID: 125911
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 125912
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125913
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125914
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125915
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125916
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 125917
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892672
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 125918
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923822
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125919
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923828
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125920
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923826
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0