CMS Formulary

Displaying 123721-123730 of 1611142 results.
ID: 123721
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123722
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123723
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123724
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123725
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123726
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123727
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 864706
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123728
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049611
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123729
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049618
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123730
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884535
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30