CMS Formulary

Displaying 123421-123430 of 1611142 results.
ID: 123421
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200658
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123422
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2200650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123423
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 847241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123424
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 153095
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123425
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197590
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123426
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197591
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123427
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123428
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123429
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123430
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0