CMS Formulary

Displaying 121681-121690 of 1611142 results.
ID: 121681
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1369736
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121682
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1940376
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121683
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1940372
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121684
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2197501
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121685
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2396770
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 121686
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2396774
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 14
Qty Limit Days: 28
ID: 121687
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 727816
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 121688
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650901
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 28
ID: 121689
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1370982
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121690
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 809477
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30