CMS Formulary

Displaying 120961-120970 of 1611142 results.
ID: 120961
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283858
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120962
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 562704
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120963
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312849
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120964
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997229
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120965
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997223
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120966
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120967
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120968
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898723
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120969
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898687
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120970
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898690
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30