CMS Formulary

Displaying 122421-122430 of 1611142 results.
ID: 122421
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308135
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122422
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122423
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 826612
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122424
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848140
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122425
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848131
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122426
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848145
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122427
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848151
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122428
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848135
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122429
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 672149
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122430
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0