CMS Formulary

Displaying 122271-122280 of 1611142 results.
ID: 122271
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1488667
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122272
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1488671
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122273
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1488675
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122274
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1488679
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122275
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1858833
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122276
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2261800
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 122277
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1799001
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122278
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790317
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122279
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122280
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242120
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0