CMS Formulary

Displaying 122391-122400 of 1611142 results.
ID: 122391
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309113
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122392
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200345
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122393
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197903
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122394
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197904
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122395
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197905
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122396
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311353
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122397
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311354
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122398
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197884
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122399
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197885
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122400
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197886
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30