CMS Formulary

Displaying 122321-122330 of 1611142 results.
ID: 122321
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122322
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122323
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122324
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122325
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 106351
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122326
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198241
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122327
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198242
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122328
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308136
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122329
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197361
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122330
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310432
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0