CMS Formulary

Displaying 122481-122490 of 1611142 results.
ID: 122481
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312832
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122482
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314211
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122483
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199890
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122484
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 845488
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122485
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861736
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122486
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861740
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122487
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122488
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 359500
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122489
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577315
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122490
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577317
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0