CMS Formulary

Displaying 125971-125980 of 1611142 results.
ID: 125971
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125972
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125973
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125974
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125975
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125976
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125977
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125978
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125979
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125980
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0