CMS Formulary

Displaying 122991-123000 of 1611142 results.
ID: 122991
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122992
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122993
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 122994
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122995
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122996
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122997
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122998
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122999
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3000
Qty Limit Days: 30
ID: 123000
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30