CMS Formulary

Displaying 120721-120730 of 1611142 results.
ID: 120721
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 260243
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120722
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312641
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120723
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1312625
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120724
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905222
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120725
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197855
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120726
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197856
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120727
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897683
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120728
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314184
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120729
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311918
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 120730
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30