CMS Formulary

Displaying 123371-123380 of 1611142 results.
ID: 123371
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859835
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123372
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123373
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1099687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123374
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312036
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123375
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5400
Qty Limit Days: 30
ID: 123376
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 834137
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123377
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123378
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123379
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123380
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30