CMS Formulary

Displaying 123311-123320 of 1611142 results.
ID: 123311
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476179
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123312
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 123313
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199703
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123314
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123315
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485440
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123316
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 899511
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123317
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 899439
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123318
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006608
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123319
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835894
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123320
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835925
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0