CMS Formulary

Displaying 122681-122690 of 1611142 results.
ID: 122681
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1862590
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122682
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831246
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122683
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809416
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122684
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 849515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122685
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 833008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122686
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 883826
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122687
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659929
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122688
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122689
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058906
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122690
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049133
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0