CMS Formulary

Displaying 120561-120570 of 1611142 results.
ID: 120561
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946525
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120562
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996615
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120563
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996594
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120564
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996603
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120565
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996609
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120566
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966920
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120567
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120568
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1540356
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120569
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992475
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120570
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995258
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0