CMS Formulary

Displaying 120201-120210 of 1611142 results.
ID: 120201
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1869699
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120202
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1805427
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120203
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602588
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120204
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1805422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120205
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120206
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1858971
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 120207
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751620
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120208
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751623
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120209
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751616
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120210
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 827075
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30