CMS Formulary

Displaying 120811-120820 of 1611142 results.
ID: 120811
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120812
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1013930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120813
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120814
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1043025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120815
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1043031
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120816
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120817
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1372999
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120818
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855858
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120819
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313306
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120820
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 348472
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0