CMS Formulary

Displaying 120781-120790 of 1611142 results.
ID: 120781
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2361313
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120782
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1293504
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120783
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149378
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120784
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790533
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120785
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791560
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120786
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120787
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791569
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120788
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791576
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120789
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1791582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120790
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149370
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30