CMS Formulary

Displaying 125981-125990 of 1611142 results.
ID: 125981
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125982
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 125983
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833709
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125984
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833711
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125985
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833713
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125986
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125987
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125988
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125989
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 125990
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30