CMS Formulary

Displaying 122401-122410 of 1611142 results.
ID: 122401
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197887
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122402
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314203
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122403
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312749
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122404
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199353
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122405
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199351
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122406
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199352
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122407
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198189
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122408
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 261962
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122409
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199147
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122410
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349491
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30