CMS Formulary

Displaying 120571-120580 of 1611142 results.
ID: 120571
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297753
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120572
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297757
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120573
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310992
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120574
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049621
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120575
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2101899
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120576
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049683
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 120577
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049686
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120578
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120579
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 899557
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120580
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 899518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30