CMS Formulary

Displaying 122281-122290 of 1611142 results.
ID: 122281
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652639
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122282
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 628958
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122283
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861646
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122284
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861650
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122285
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861654
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122286
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349591
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122287
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349592
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122288
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349593
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122289
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011736
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122290
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011739
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30