CMS Formulary

Displaying 123531-123540 of 1611142 results.
ID: 123531
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123532
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123533
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123534
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123535
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123536
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123537
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123538
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123539
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123540
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30