CMS Formulary

Displaying 125941-125950 of 1611142 results.
ID: 125941
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125942
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125943
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125944
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125945
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125946
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125947
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125948
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125949
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125950
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0