CMS Formulary

Displaying 120511-120520 of 1611142 results.
ID: 120511
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991194
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120512
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991336
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120513
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120514
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991188
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120515
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 584414
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120516
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857297
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120517
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857301
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120518
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120519
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1596780
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120520
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855292
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0