CMS Formulary

Displaying 120601-120610 of 1611142 results.
ID: 120601
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864718
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 120602
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197593
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120603
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199168
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120604
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312357
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120605
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312362
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120606
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2106334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 120607
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1661220
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120608
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120609
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854876
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120610
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283672
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0