CMS Formulary

Displaying 121111-121120 of 1611142 results.
ID: 121111
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2001430
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121112
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2003255
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121113
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2043464
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121114
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121115
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 865208
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121116
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 865212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121117
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 865216
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121118
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 723827
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 121119
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 729201
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121120
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 729203
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30