CMS Formulary

Displaying 121331-121340 of 1611142 results.
ID: 121331
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313227
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121332
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857366
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121333
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121334
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308715
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121335
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121336
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848176
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121337
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121338
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121339
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896110
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121340
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191310
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0