CMS Formulary

Displaying 123711-123720 of 1611142 results.
ID: 123711
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 886634
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 123712
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1437702
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123713
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857002
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123714
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 857005
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123715
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 856999
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123716
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993781
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 123717
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123718
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123719
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123720
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30