CMS Formulary

Displaying 120151-120160 of 1611142 results.
ID: 120151
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049221
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120152
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120153
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049214
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120154
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091497
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120155
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091392
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120156
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091145
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120157
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120158
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897696
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 120159
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897702
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 120160
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897710
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30