CMS Formulary

Displaying 120831-120840 of 1611142 results.
ID: 120831
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 884185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120832
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 884189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120833
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120834
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996571
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120835
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 996561
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120836
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854916
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120837
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854919
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120838
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854908
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120839
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 201708
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120840
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 248420
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30