CMS Formulary

Displaying 123781-123790 of 1611142 results.
ID: 123781
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 833146
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123782
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123783
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123784
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433229
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123785
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433235
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123786
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1433241
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123787
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123788
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123789
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 859979
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123790
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30