CMS Formulary

Displaying 122881-122890 of 1611142 results.
ID: 122881
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1593140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 122882
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122883
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1547110
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122884
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243848
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122885
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243843
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122886
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243833
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122887
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 665044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122888
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 665040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122889
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 744846
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122890
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 665036
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30