CMS Formulary

Displaying 121281-121290 of 1611142 results.
ID: 121281
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 724156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121282
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121283
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1739788
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 121284
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1149617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121285
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213197
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121286
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997010
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121287
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866427
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121288
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866412
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121289
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866419
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121290
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198034
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30