CMS Formulary

Displaying 120841-120850 of 1611142 results.
ID: 120841
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351172
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120842
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199422
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120843
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200082
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120844
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199663
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120845
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905199
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120846
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905225
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120847
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905395
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120848
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198371
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120849
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120850
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197818
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0