CMS Formulary

Displaying 122371-122380 of 1611142 results.
ID: 122371
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122372
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313570
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122373
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313571
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 122374
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309049
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122375
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122376
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105171
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122377
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995599
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122378
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995607
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122379
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 307650
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122380
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309097
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0