CMS Formulary

Displaying 121731-121740 of 1611142 results.
ID: 121731
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121732
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121733
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121734
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121735
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121736
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121737
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1048450
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121738
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1048445
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121739
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855626
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121740
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607617
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30