CMS Formulary

Displaying 123281-123290 of 1611142 results.
ID: 123281
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123282
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123283
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 123284
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123285
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123286
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123287
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123288
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 753543
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123289
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2110455
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123290
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30