CMS Formulary

Displaying 120891-120900 of 1611142 results.
ID: 120891
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2045201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120892
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120893
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 239240
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120894
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1596108
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 120895
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 809871
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120896
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197873
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120897
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058845
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120898
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864661
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120899
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2001424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120900
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1363408
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0