CMS Formulary

Displaying 120361-120370 of 1611142 results.
ID: 120361
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597123
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120362
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597129
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120363
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 238134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120364
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1745091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120365
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120366
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311892
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120367
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120368
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199521
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120369
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996572
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120370
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0