CMS Formulary

Displaying 122341-122350 of 1611142 results.
ID: 122341
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197806
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122342
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197807
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122343
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311347
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122344
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311204
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122345
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 898715
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 900
Qty Limit Days: 30
ID: 122346
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 282755
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122347
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205304
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122348
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205305
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122349
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 409823
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122350
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892582
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30