CMS Formulary

Displaying 123341-123350 of 1611142 results.
ID: 123341
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123342
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123343
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123344
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123345
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123346
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123347
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123348
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123349
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123350
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0