CMS Formulary

Displaying 121961-121970 of 1611142 results.
ID: 121961
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859975
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121962
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283316
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121963
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283317
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 121964
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121965
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121966
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121967
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121968
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121969
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121970
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0