CMS Formulary

Displaying 122651-122660 of 1611142 results.
ID: 122651
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1796922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122652
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122653
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744001
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122654
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744005
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122655
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1744009
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122656
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122657
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313988
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122658
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309307
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122659
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790684
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122660
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197854
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0