CMS Formulary

Displaying 120031-120040 of 1611142 results.
ID: 120031
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197465
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 120032
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197466
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120033
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198286
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120034
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120035
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120036
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120037
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120038
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120039
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120040
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0