CMS Formulary

Displaying 121571-121580 of 1611142 results.
ID: 121571
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200258
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 121572
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313582
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121573
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121574
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314277
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121575
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313586
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121576
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311759
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121577
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866511
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121578
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866514
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121579
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 476809
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121580
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197499
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0