CMS Formulary

Displaying 120701-120710 of 1611142 results.
ID: 120701
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856762
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120702
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856773
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120703
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 429503
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120704
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310798
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120705
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197770
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120706
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 485023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120707
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309362
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120708
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198223
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120709
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 485020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120710
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856364
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0