CMS Formulary

Displaying 121691-121700 of 1611142 results.
ID: 121691
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123137
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121692
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121693
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123145
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121694
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1102277
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121695
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205918
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121696
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121697
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205924
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121698
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721690
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121699
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 212219
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121700
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213475
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0