CMS Formulary

Displaying 123771-123780 of 1611142 results.
ID: 123771
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123772
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 123773
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123774
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123775
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123776
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123777
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833151
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123778
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833139
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123779
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123780
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833149
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0