CMS Formulary

Displaying 121221-121230 of 1611142 results.
ID: 121221
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1722376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121222
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2100099
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 121223
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2100100
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 121224
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054310
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121225
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054313
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121226
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121227
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054318
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121228
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312614
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121229
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283077
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121230
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993755
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 4500
Qty Limit Days: 30