CMS Formulary

Displaying 120971-120980 of 1611142 results.
ID: 120971
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898719
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120972
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1100184
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120973
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857169
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120974
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857183
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120975
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857187
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120976
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197732
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120977
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312750
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120978
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312748
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120979
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312079
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120980
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 208185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0