CMS Formulary

Displaying 121581-121590 of 1611142 results.
ID: 121581
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197500
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121582
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198105
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121583
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198104
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121584
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1662285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121585
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 999967
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121586
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 999996
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121587
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 999986
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121588
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000001
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121589
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 999991
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121590
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 984082
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0