CMS Formulary

Displaying 121711-121720 of 1611142 results.
ID: 121711
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121712
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2373941
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121713
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049677
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121714
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762675
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121715
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 259966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121716
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197973
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121717
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121718
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121719
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121720
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0