CMS Formulary

Displaying 121321-121330 of 1611142 results.
ID: 121321
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121322
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121323
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121324
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121325
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 204135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121326
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1370754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121327
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1370750
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121328
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861487
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121329
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992281
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121330
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 203088
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30