CMS Formulary

Displaying 122251-122260 of 1611142 results.
ID: 122251
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1800500
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122252
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992150
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122253
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 724863
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122254
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 724859
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122255
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 724861
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122256
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403818
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122257
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897021
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122258
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049264
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122259
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1856424
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122260
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2052064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0