CMS Formulary

Displaying 121811-121820 of 1611142 results.
ID: 121811
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314155
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121812
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351107
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121813
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859193
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121814
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 686379
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121815
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855818
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121816
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855812
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121817
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121818
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665093
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121819
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121820
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0