CMS Formulary

Displaying 122181-122190 of 1611142 results.
ID: 122181
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 315223
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 122182
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313161
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 122183
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313160
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 122184
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854873
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122185
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310796
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122186
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310797
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122187
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310809
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122188
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122189
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312086
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122190
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310384
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0