CMS Formulary

Displaying 125961-125970 of 1611142 results.
ID: 125961
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125962
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125963
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125964
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125965
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125966
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 125967
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125968
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125969
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125970
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30