CMS Formulary

Displaying 121341-121350 of 1611142 results.
ID: 121341
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246096
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121342
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313200
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121343
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 103456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121344
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310891
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121345
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121346
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197686
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121347
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197303
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121348
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121349
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197853
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121350
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858813
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30