CMS Formulary

Displaying 122871-122880 of 1611142 results.
ID: 122871
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122872
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 607579
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122873
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122874
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122875
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 74
Qty Limit Days: 30
ID: 122876
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122877
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122878
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122879
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122880
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404460
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30