CMS Formulary

Displaying 121151-121160 of 1611142 results.
ID: 121151
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197987
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121152
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197986
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121153
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121154
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860215
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121155
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860221
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121156
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198056
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121157
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351276
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121158
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349194
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121159
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121160
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349198
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30