CMS Formulary

Displaying 121101-121110 of 1611142 results.
ID: 121101
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 807225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 121102
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486496
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 121103
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763106
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 121104
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658241
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 121105
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1939299
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121106
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1939348
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121107
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577324
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121108
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 727316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 121109
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1870207
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 121110
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1374574
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30