CMS Formulary

Displaying 122511-122520 of 1611142 results.
ID: 122511
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 122512
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122513
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122514
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122515
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122516
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403966
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122517
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122518
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358776
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122519
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309367
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122520
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198014
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0