CMS Formulary

Displaying 123681-123690 of 1611142 results.
ID: 123681
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 351136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123682
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1855389
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123683
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 728550
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 123684
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199689
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123685
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 603208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123686
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 603203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123687
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123688
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123689
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123690
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0