CMS Formulary

Displaying 123851-123860 of 1611142 results.
ID: 123851
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000141
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123852
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197658
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123853
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123854
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123855
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 541878
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123856
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 541892
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123857
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577961
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123858
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 541363
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123859
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404059
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123860
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0