CMS Formulary

Displaying 122591-122600 of 1611142 results.
ID: 122591
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122592
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122593
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830845
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122594
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830837
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122595
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 830801
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122596
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 352257
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 540
Qty Limit Days: 30
ID: 122597
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364477
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122598
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602028
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122599
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602034
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122600
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1602040
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0