CMS Formulary

Displaying 123191-123200 of 1611142 results.
ID: 123191
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 825425
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123192
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 825429
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123193
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884619
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123194
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2121061
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123195
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1656356
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123196
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1859501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123197
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1919094
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123198
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2169314
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123199
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2169322
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123200
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2362240
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30