CMS Formulary

Displaying 123291-123300 of 1611142 results.
ID: 123291
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918194
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 123292
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1918203
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 123293
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904870
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 123294
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904876
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 123295
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312594
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123296
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123297
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123298
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123299
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123300
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0