CMS Formulary

Displaying 121941-121950 of 1611142 results.
ID: 121941
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121942
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121943
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121944
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121945
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121946
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312847
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121947
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121948
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121949
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 643019
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 121950
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 643022
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30