CMS Formulary

Displaying 121031-121040 of 1611142 results.
ID: 121031
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597120
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121032
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597126
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121033
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310982
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 30
ID: 121034
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313189
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121035
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309290
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121036
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121037
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313852
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121038
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 106336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121039
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121040
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 543460
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0