CMS Formulary

Displaying 123471-123480 of 1611142 results.
ID: 123471
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123472
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123473
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123474
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123475
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 123476
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 123477
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123478
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123479
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1539762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123480
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30