CMS Formulary

Displaying 121431-121440 of 1611142 results.
ID: 121431
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121432
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121433
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121434
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 152
Qty Limit Days: 30
ID: 121435
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121436
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121437
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121438
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121439
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121440
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0