CMS Formulary

Displaying 122151-122160 of 1611142 results.
ID: 122151
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 825134
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122152
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801519
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122153
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 539789
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122154
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856666
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122155
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122156
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122157
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122158
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122159
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122160
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0