CMS Formulary

Displaying 123221-123230 of 1611142 results.
ID: 123221
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123222
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123223
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246313
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 123224
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246310
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 123225
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123226
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123227
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123228
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123229
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123230
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0