CMS Formulary

Displaying 122911-122920 of 1611142 results.
ID: 122911
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 999
ID: 122912
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658102
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 999
ID: 122913
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 798451
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 122914
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830263
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 122915
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 122916
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2055815
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122917
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122918
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122919
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122920
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0