CMS Formulary

Displaying 121951-121960 of 1611142 results.
ID: 121951
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866482
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121952
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866479
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121953
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349401
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121954
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349405
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121955
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121956
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205323
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121957
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403853
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121958
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403854
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121959
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403855
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121960
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859981
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30