CMS Formulary

Displaying 120691-120700 of 1611142 results.
ID: 120691
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197528
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120692
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197529
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 120693
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312744
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120694
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616487
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120695
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120696
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349332
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120697
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120698
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856834
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120699
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120700
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856853
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0