CMS Formulary

Displaying 123641-123650 of 1611142 results.
ID: 123641
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123642
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123643
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123644
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123645
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 606726
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123646
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 606730
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123647
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123648
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198325
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123649
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198323
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123650
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 855942
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0