CMS Formulary

Displaying 120101-120110 of 1611142 results.
ID: 120101
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120102
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 260350
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120103
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 260351
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120104
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 432401
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120105
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120106
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 226552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120107
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120108
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120109
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404061
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120110
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0