CMS Formulary

Displaying 123161-123170 of 1611142 results.
ID: 123161
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966251
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123162
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123163
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123164
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123165
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123166
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123167
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123168
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123169
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123170
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30