CMS Formulary

Displaying 120271-120280 of 1611142 results.
ID: 120271
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000405
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120272
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120273
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977883
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120274
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120275
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197556
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120276
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197554
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120277
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197555
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120278
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120279
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1009145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120280
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 687043
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30