CMS Formulary

Displaying 121021-121030 of 1611142 results.
ID: 121021
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 238151
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 121022
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 151030
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121023
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977990
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121024
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977978
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121025
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309289
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121026
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309291
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121027
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 705129
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121028
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 895487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121029
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 895987
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121030
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 797274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0