CMS Formulary

Displaying 123511-123520 of 1611142 results.
ID: 123511
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123512
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123513
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123514
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123515
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 999965
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123516
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123517
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204520
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123518
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601982
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123519
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1799890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123520
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0