CMS Formulary

Displaying 120981-120990 of 1611142 results.
ID: 120981
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577127
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120982
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403908
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120983
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198038
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120984
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198039
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120985
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120986
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010600
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120987
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307056
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 120988
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010604
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 120989
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120990
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351223
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0