CMS Formulary

Displaying 122671-122680 of 1611142 results.
ID: 122671
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200132
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 122672
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199149
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 122673
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199150
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122674
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311915
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122675
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1867544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122676
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1725064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122677
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437713
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122678
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1918242
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 122679
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862595
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122680
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921589
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30