CMS Formulary

Displaying 123151-123160 of 1611142 results.
ID: 123151
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123152
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966158
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123153
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123154
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966171
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123155
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123156
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966250
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123157
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123158
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123159
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123160
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0