CMS Formulary

Displaying 121411-121420 of 1611142 results.
ID: 121411
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856481
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121412
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860654
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121413
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1014673
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121414
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866144
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121415
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199450
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121416
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 246172
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121417
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1606337
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121418
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313498
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121419
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313499
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121420
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313496
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0