CMS Formulary

Displaying 121821-121830 of 1611142 results.
ID: 121821
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091650
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121822
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091654
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121823
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1235150
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121824
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1235157
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121825
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121826
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121827
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121828
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121829
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121830
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0