CMS Formulary

Displaying 122411-122420 of 1611142 results.
ID: 122411
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 853201
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122412
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649990
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122413
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122414
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122415
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 728109
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122416
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312122
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122417
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 833709
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122418
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 833711
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122419
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 833713
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122420
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0