CMS Formulary

Displaying 120621-120630 of 1611142 results.
ID: 120621
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120622
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120623
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 602964
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120624
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402131
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120625
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349545
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120626
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349490
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120627
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349553
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120628
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349547
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120629
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856373
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120630
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310288
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0