CMS Formulary

Displaying 123501-123510 of 1611142 results.
ID: 123501
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123502
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123503
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123504
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123505
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123506
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123507
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123508
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123509
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123510
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0