CMS Formulary

Displaying 121891-121900 of 1611142 results.
ID: 121891
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121892
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121893
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121894
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121895
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667670
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121896
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667674
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121897
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1667678
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121898
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1741747
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121899
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809471
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121900
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243346
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30