CMS Formulary

Displaying 123991-124000 of 1611142 results.
ID: 123991
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123992
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123993
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123994
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123995
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 123996
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123997
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123998
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123999
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124000
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0