CMS Formulary

Displaying 120801-120810 of 1611142 results.
ID: 120801
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120802
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120803
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120804
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120805
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120806
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120807
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1361574
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120808
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351246
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120809
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317094
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120810
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349435
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0