CMS Formulary

Displaying 123061-123070 of 1611142 results.
ID: 123061
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123062
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213320
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123063
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123064
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123065
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123066
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123067
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123068
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123069
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123070
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30