CMS Formulary

Displaying 122291-122300 of 1611142 results.
ID: 122291
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 388311
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122292
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122293
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200131
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122294
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896184
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122295
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122296
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896228
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122297
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861237
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122298
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861221
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122299
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122300
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861225
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30