CMS Formulary

Displaying 121401-121410 of 1611142 results.
ID: 121401
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312839
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 121402
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312837
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 121403
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359127
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121404
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091341
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 121405
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359124
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121406
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121407
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310599
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121408
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856535
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121409
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121410
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0