CMS Formulary

Displaying 120401-120410 of 1611142 results.
ID: 120401
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243026
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120402
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1545664
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120403
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1545668
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120404
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1651275
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 120405
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664321
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120406
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667882
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 120407
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602120
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120408
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665369
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120409
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664328
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120410
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1664325
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30