CMS Formulary

Displaying 123761-123770 of 1611142 results.
ID: 123761
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123762
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123763
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123764
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123765
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123766
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123767
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123768
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123769
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123770
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30