CMS Formulary

Displaying 120241-120250 of 1611142 results.
ID: 120241
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120242
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120243
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120244
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120245
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245373
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120246
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120247
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314078
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120248
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197635
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120249
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197634
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120250
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 238154
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30