CMS Formulary

Displaying 120071-120080 of 1611142 results.
ID: 120071
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966248
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120072
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966224
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120073
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966225
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120074
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966249
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120075
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892251
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120076
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892255
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120077
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966270
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120078
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349477
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120079
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 606726
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120080
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 606730
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30