CMS Formulary

Displaying 122571-122580 of 1611142 results.
ID: 122571
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1812011
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122572
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1812013
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122573
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 562806
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 122574
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 825130
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122575
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 260260
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122576
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1370758
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122577
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311382
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122578
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1366550
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122579
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861668
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 122580
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830795
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0