CMS Formulary

Displaying 122711-122720 of 1611142 results.
ID: 122711
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122712
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122713
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577348
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122714
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992873
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122715
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2119706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122716
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349287
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122717
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313362
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122718
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122719
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122720
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197558
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0