CMS Formulary

Displaying 123331-123340 of 1611142 results.
ID: 123331
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123332
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123333
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123334
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123335
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123336
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123337
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123338
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123339
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123340
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30