CMS Formulary

Displaying 123001-123010 of 1611142 results.
ID: 123001
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997170
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123002
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123003
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123004
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123005
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123006
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123007
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123008
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123009
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123010
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0