CMS Formulary

Displaying 120871-120880 of 1611142 results.
ID: 120871
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859751
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120872
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859419
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120873
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199192
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120874
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199193
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120875
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198382
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120876
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997226
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120877
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997220
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120878
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349201
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120879
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120880
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312078
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30