CMS Formulary

Displaying 120411-120420 of 1611142 results.
ID: 120411
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602115
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120412
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796091
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120413
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796096
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120414
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862688
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120415
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862701
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120416
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862697
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120417
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862692
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120418
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1037181
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120419
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1037049
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120420
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359285
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30