CMS Formulary

Displaying 123301-123310 of 1611142 results.
ID: 123301
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123302
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123303
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123304
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123305
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123306
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123307
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1652084
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123308
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006801
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123309
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 996921
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123310
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 721773
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30