CMS Formulary

Displaying 120791-120800 of 1611142 results.
ID: 120791
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149373
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120792
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149376
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120793
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1812015
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120794
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 862006
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120795
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120796
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120797
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120798
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 201388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120799
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120800
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0