CMS Formulary

Displaying 121461-121470 of 1611142 results.
ID: 121461
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206791
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 121462
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 580286
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 121463
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1313785
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121464
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207588
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121465
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213510
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121466
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1433736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121467
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310386
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121468
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 121469
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121470
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1605088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0