CMS Formulary

Displaying 120551-120560 of 1611142 results.
ID: 120551
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1719803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120552
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866103
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120553
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 672567
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120554
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 672569
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120555
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 672571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120556
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207249
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120557
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993541
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120558
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993557
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120559
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946529
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120560
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946527
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30