CMS Formulary

Displaying 122231-122240 of 1611142 results.
ID: 122231
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898359
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122232
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898342
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122233
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898346
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122234
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 562266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122235
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 863669
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122236
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122237
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402246
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122238
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402247
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122239
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 664741
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122240
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 833528
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0