CMS Formulary

Displaying 121241-121250 of 1611142 results.
ID: 121241
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1439896
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121242
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1439899
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121243
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1439901
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121244
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1439903
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121245
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105657
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 121246
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105645
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121247
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105653
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 121248
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2180336
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121249
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 615979
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121250
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402252
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0