CMS Formulary

Displaying 123911-123920 of 1611142 results.
ID: 123911
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314006
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123912
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 315107
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123913
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310489
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 123914
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 250344
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123915
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 722122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123916
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 722116
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123917
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123918
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123919
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1080
Qty Limit Days: 30
ID: 123920
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0