CMS Formulary

Displaying 121921-121930 of 1611142 results.
ID: 121921
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1858267
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121922
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1939335
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121923
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1999673
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121924
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 315183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121925
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121926
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831255
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121927
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831309
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121928
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831338
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121929
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121930
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831248
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0