CMS Formulary

Displaying 122301-122310 of 1611142 results.
ID: 122301
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861227
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122302
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861232
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122303
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1367436
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122304
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 647237
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122305
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 647239
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122306
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198313
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122307
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198312
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122308
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 352210
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122309
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198175
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122310
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1490032
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30