CMS Formulary

Displaying 122581-122590 of 1611142 results.
ID: 122581
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831359
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122582
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313453
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122583
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 359050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122584
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801957
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 122585
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801961
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 122586
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801966
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 5
Qty Limit Days: 30
ID: 122587
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830877
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122588
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830879
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122589
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830882
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122590
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0