CMS Formulary

Displaying 120131-120140 of 1611142 results.
ID: 120131
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120132
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120133
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120134
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310169
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120135
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 209789
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120136
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 209788
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120137
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120138
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 486148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120139
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 486152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120140
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 486146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0