CMS Formulary

Displaying 120661-120670 of 1611142 results.
ID: 120661
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866436
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120662
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855633
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120663
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607784
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120664
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199245
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 120665
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199246
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120666
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199247
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120667
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314231
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120668
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312961
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120669
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198211
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120670
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200060
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0