CMS Formulary

Displaying 123971-123980 of 1611142 results.
ID: 123971
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123972
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 123973
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123974
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123975
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123976
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123977
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123978
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123979
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 123980
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30