CMS Formulary

Displaying 120421-120430 of 1611142 results.
ID: 120421
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120422
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359353
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120423
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2359358
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120424
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991082
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120425
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 702519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120426
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120427
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 885219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120428
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 885213
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120429
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049635
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120430
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0