CMS Formulary

Displaying 122501-122510 of 1611142 results.
ID: 122501
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122502
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122503
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988311
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122504
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122505
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988319
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122506
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122507
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988330
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122508
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122509
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 122510
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30