CMS Formulary

Displaying 122221-122230 of 1611142 results.
ID: 122221
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 636045
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122222
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 251872
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122223
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122224
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122225
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349199
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122226
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349200
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122227
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200224
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122228
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898350
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122229
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122230
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898356
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30