CMS Formulary

Displaying 123011-123020 of 1611142 results.
ID: 123011
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123012
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 123013
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3900
Qty Limit Days: 30
ID: 123014
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123015
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123016
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123017
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123018
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123019
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123020
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1304979
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0