CMS Formulary

Displaying 121351-121360 of 1611142 results.
ID: 121351
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858817
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121352
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858810
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121353
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308973
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121354
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858824
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121355
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858828
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121356
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308976
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121357
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121358
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121359
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310380
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121360
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0