CMS Formulary

Displaying 120931-120940 of 1611142 results.
ID: 120931
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 891893
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 120932
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 891874
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120933
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892646
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120934
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848726
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120935
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848738
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120936
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848742
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120937
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848746
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120938
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848750
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120939
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848730
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120940
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848734
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30