CMS Formulary

Displaying 122111-122120 of 1611142 results.
ID: 122111
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1116758
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122112
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 543492
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122113
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440936
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122114
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122115
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313428
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122116
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242680
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 960
Qty Limit Days: 30
ID: 122117
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205292
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122118
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205290
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122119
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 315134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122120
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866021
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0