CMS Formulary

Displaying 123691-123700 of 1611142 results.
ID: 123691
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123692
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123693
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123694
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1095224
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123695
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123696
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123697
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1607990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123698
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123699
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123700
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0