CMS Formulary

Displaying 120881-120890 of 1611142 results.
ID: 120881
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314154
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120882
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283639
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120883
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200284
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120884
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312076
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120885
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351108
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120886
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349251
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120887
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861822
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120888
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1095712
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120889
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665515
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120890
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1719286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0