CMS Formulary

Displaying 121541-121550 of 1611142 results.
ID: 121541
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 352262
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121542
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 731229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121543
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121544
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180
ID: 121545
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1046402
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121546
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121547
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649495
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121548
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2168596
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 450
Qty Limit Days: 30
ID: 121549
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2045638
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 121550
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2120195
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30