CMS Formulary

Displaying 122561-122570 of 1611142 results.
ID: 122561
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122562
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122563
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122564
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122565
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1989507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122566
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1876920
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122567
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1876924
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122568
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1876916
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122569
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308725
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122570
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855657
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0