CMS Formulary

Displaying 123381-123390 of 1611142 results.
ID: 123381
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 123382
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123383
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123384
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 123385
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123386
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123387
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123388
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123389
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123390
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1550940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30