CMS Formulary

Displaying 123351-123360 of 1611142 results.
ID: 123351
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123352
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123353
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123354
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123355
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123356
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 123357
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 123358
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123359
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123360
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0