CMS Formulary

Displaying 123411-123420 of 1611142 results.
ID: 123411
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123412
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670023
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123413
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1670016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123414
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2107522
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123415
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616238
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123416
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30
ID: 123417
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2398842
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 123418
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1991311
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 123419
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1991317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 123420
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30