CMS Formulary

Displaying 122201-122210 of 1611142 results.
ID: 122201
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854925
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122202
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857166
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122203
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 857174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122204
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904431
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 28
ID: 122205
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312087
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122206
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198334
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122207
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198335
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122208
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979468
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122209
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979464
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122210
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979471
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30