CMS Formulary

Displaying 122471-122480 of 1611142 results.
ID: 122471
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 979092
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122472
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738483
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122473
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738495
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122474
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1738503
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122475
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099596
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122476
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197412
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122477
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312828
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122478
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312829
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122479
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312830
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122480
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312831
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0