CMS Formulary

Displaying 121901-121910 of 1611142 results.
ID: 121901
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243326
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121902
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243330
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121903
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243229
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121904
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404587
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121905
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616148
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 850
Qty Limit Days: 30
ID: 121906
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 639888
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121907
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744003
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121908
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744007
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121909
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744011
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121910
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 901614
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0