CMS Formulary

Displaying 123171-123180 of 1611142 results.
ID: 123171
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123172
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123173
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123174
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123175
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123176
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123177
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364122
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123178
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653243
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123179
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1599797
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123180
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603361
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0