CMS Formulary

Displaying 123951-123960 of 1611142 results.
ID: 123951
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197382
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123952
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 805515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 380
Qty Limit Days: 30
ID: 123953
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 603378
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 123954
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 20
ID: 123955
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 580261
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123956
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836368
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123957
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1552004
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 123958
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1723478
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123959
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430453
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123960
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1430457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0