CMS Formulary

Displaying 122611-122620 of 1611142 results.
ID: 122611
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1495070
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122612
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199888
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122613
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 151226
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122614
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199889
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122615
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311486
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122616
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904396
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 122617
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199672
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 122618
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 252559
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122619
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 239238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122620
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 602393
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30