CMS Formulary

Displaying 122191-122200 of 1611142 results.
ID: 122191
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310385
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122192
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313989
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122193
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979485
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122194
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979492
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122195
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979480
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122196
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 248109
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122197
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314108
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122198
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311290
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122199
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854984
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122200
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854988
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30