CMS Formulary

Displaying 123541-123550 of 1611142 results.
ID: 123541
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123542
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123543
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1790644
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 123544
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 123545
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123546
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123547
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043567
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123548
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123549
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1043574
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123550
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486981
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30