CMS Formulary

Displaying 121071-121080 of 1611142 results.
ID: 121071
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1098143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121072
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200174
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121073
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200177
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121074
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200180
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121075
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2200183
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121076
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1648755
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121077
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 725021
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121078
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 725023
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121079
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311995
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121080
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1648759
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0