CMS Formulary

Displaying 120681-120690 of 1611142 results.
ID: 120681
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120682
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1483744
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120683
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310346
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120684
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 721791
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120685
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 721794
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120686
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 721796
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120687
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 895670
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120688
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197319
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120689
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197320
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120690
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197527
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30