CMS Formulary

Displaying 123831-123840 of 1611142 results.
ID: 123831
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123832
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349196
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123833
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 349197
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 123834
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123835
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123836
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123837
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123838
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123839
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123840
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0