CMS Formulary

Displaying 122531-122540 of 1611142 results.
ID: 122531
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 608143
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122532
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 608139
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122533
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122534
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122535
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855480
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122536
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855474
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122537
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749860
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122538
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198373
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122539
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1094543
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122540
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0