CMS Formulary

Displaying 122131-122140 of 1611142 results.
ID: 122131
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857336
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122132
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857321
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122133
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857328
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122134
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857340
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122135
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 259081
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122136
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835603
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 122137
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283536
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122138
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199387
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122139
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312085
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122140
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308429
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0