CMS Formulary

Displaying 123021-123030 of 1611142 results.
ID: 123021
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 123022
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123023
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123024
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123025
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123026
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123027
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123028
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123029
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123030
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0