CMS Formulary

Displaying 121061-121070 of 1611142 results.
ID: 121061
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 259306
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121062
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1799654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121063
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105292
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121064
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199592
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121065
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 483090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121066
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 476399
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121067
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 476515
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121068
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 805464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121069
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659927
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121070
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403878
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30