CMS Formulary

Displaying 120121-120130 of 1611142 results.
ID: 120121
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 603206
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120122
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748961
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120123
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751901
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120124
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 810096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120125
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749761
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120126
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748868
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120127
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 759743
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120128
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1095224
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120129
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748806
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120130
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748804
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0