CMS Formulary

Displaying 121131-121140 of 1611142 results.
ID: 121131
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2374566
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 121132
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197839
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121133
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313447
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121134
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861402
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121135
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121136
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121137
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121138
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121139
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121140
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0