CMS Formulary

Displaying 122001-122010 of 1611142 results.
ID: 122001
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1356580
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122002
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1356584
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122003
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1356588
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122004
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 720
Qty Limit Days: 30
ID: 122005
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 824299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122006
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 824303
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122007
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1092360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122008
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054157
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122009
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796665
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122010
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1604384
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0