CMS Formulary

Displaying 122551-122560 of 1611142 results.
ID: 122551
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864675
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122552
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835726
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122553
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349373
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122554
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314266
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122555
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311877
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122556
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122557
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122558
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866905
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122559
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122560
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0