CMS Formulary

Displaying 123731-123740 of 1611142 results.
ID: 123731
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884532
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123732
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 245136
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 123733
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 245134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 123734
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 245135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 123735
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197696
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 15
Qty Limit Days: 30
ID: 123736
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1870650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123737
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123738
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123739
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123740
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0