CMS Formulary

Displaying 121781-121790 of 1611142 results.
ID: 121781
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121782
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 328160
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121783
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310490
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 121784
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 121785
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993687
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121786
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121787
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121788
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121789
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121790
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0