CMS Formulary

Displaying 122901-122910 of 1611142 results.
ID: 122901
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 798300
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 1
ID: 122902
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830253
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 122903
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 122904
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836636
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 122905
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 122906
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 122907
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1597103
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 122908
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1292443
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 122909
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 804186
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 122910
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1292459
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1