CMS Formulary

Displaying 120921-120930 of 1611142 results.
ID: 120921
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120922
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120923
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120924
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120925
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858747
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120926
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1542997
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 120927
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1432969
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 120928
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904880
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 120929
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 891881
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120930
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 891888
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30