CMS Formulary

Displaying 122141-122150 of 1611142 results.
ID: 122141
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 283523
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122142
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122143
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197746
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122144
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198358
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122145
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099569
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122146
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1244214
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122147
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197312
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122148
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 485496
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 750
Qty Limit Days: 30
ID: 122149
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 348719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 122150
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2183131
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30