CMS Formulary

Displaying 120321-120330 of 1611142 results.
ID: 120321
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312529
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120322
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977880
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120323
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2047882
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120324
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310190
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120325
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310191
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120326
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 261178
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120327
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313941
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120328
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198300
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120329
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 106303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120330
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313450
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0