CMS Formulary

Displaying 121561-121570 of 1611142 results.
ID: 121561
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 834102
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121562
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310436
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121563
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310437
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121564
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 579148
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121565
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 104894
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121566
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861132
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121567
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310352
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121568
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310353
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121569
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200257
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 121570
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200256
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30