CMS Formulary

Displaying 120851-120860 of 1611142 results.
ID: 120851
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120852
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855172
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120853
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242679
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120854
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309313
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120855
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351285
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120856
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120857
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313565
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120858
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313564
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120859
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120860
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30