CMS Formulary

Displaying 122331-122340 of 1611142 results.
ID: 122331
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122332
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317174
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122333
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312745
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122334
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616483
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122335
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312743
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122336
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 637173
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122337
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312840
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 122338
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314209
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 122339
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122340
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197805
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0