CMS Formulary

Displaying 123111-123120 of 1611142 results.
ID: 123111
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123112
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123113
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123114
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123115
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123116
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123117
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123118
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123119
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123120
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0