CMS Formulary

Displaying 120331-120340 of 1611142 results.
ID: 120331
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313451
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120332
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120333
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310149
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120334
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120335
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 284254
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120336
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197900
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120337
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197901
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120338
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197902
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 120339
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120340
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0