CMS Formulary

Displaying 122071-122080 of 1611142 results.
ID: 122071
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482517
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122072
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482523
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122073
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1482527
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122074
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122075
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1235249
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122076
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1040036
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122077
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1431237
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122078
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1040043
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122079
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1297357
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122080
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1356693
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0