CMS Formulary

Displaying 120221-120230 of 1611142 results.
ID: 120221
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1606490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120222
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859983
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120223
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859979
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120224
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307309
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120225
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2052609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120226
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2052704
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120227
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105817
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120228
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300797
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120229
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300803
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120230
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 967388
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0