CMS Formulary

Displaying 122921-122930 of 1611142 results.
ID: 122921
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122922
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122923
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122924
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122925
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122926
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122927
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 848330
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122928
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 763489
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122929
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996559
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122930
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0