CMS Formulary

Displaying 122121-122130 of 1611142 results.
ID: 122121
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992303
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122122
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 427163
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122123
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313123
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122124
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122125
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198012
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122126
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1098141
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122127
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1098134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122128
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577033
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122129
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995624
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122130
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2266506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0