CMS Formulary

Displaying 120631-120640 of 1611142 results.
ID: 120631
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197985
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120632
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197984
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120633
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 598006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120634
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120635
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 902741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120636
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 902729
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120637
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 902736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120638
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1306898
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120639
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861601
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120640
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861597
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28