CMS Formulary

Displaying 122211-122220 of 1611142 results.
ID: 122211
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198188
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122212
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313134
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122213
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 562508
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122214
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861783
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122215
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122216
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122217
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122218
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200285
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122219
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122220
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 636042
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30