CMS Formulary

Displaying 121551-121560 of 1611142 results.
ID: 121551
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1991509
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121552
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858125
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121553
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858127
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121554
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197699
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121555
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197700
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121556
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 596926
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121557
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 596930
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121558
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 596934
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121559
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121560
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 834061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0