CMS Formulary

Displaying 122311-122320 of 1611142 results.
ID: 122311
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1490036
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122312
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1490040
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122313
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122314
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1361615
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122315
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122316
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122317
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122318
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122319
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122320
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0