CMS Formulary

Displaying 123811-123820 of 1611142 results.
ID: 123811
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123812
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123813
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123814
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123815
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123816
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123817
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309844
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123818
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865117
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123819
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 865123
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123820
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860918
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0