CMS Formulary

Displaying 122971-122980 of 1611142 results.
ID: 122971
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797849
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122972
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122973
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 706467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122974
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 688242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122975
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 205739
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122976
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 208513
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122977
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122978
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122979
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122980
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30