CMS Formulary

Displaying 123791-123800 of 1611142 results.
ID: 123791
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123792
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123793
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123794
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123795
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123796
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123797
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 307730
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123798
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 106302
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123799
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 884308
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123800
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 106387
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0