CMS Formulary

Displaying 121201-121210 of 1611142 results.
ID: 121201
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242819
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 30
ID: 121202
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242815
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 121203
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616749
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121204
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 728231
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121205
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477367
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121206
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477372
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121207
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1657212
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121208
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1147228
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 121209
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2197873
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 121210
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2197877
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30