CMS Formulary

Displaying 120591-120600 of 1611142 results.
ID: 120591
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010606
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120592
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307063
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120593
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120594
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858798
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 120595
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311725
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120596
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311726
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120597
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 884386
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120598
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 884385
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120599
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993770
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30
ID: 120600
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993890
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 390
Qty Limit Days: 30