CMS Formulary

Displaying 122721-122730 of 1611142 results.
ID: 122721
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197557
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122722
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122723
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2049884
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122724
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2265701
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122725
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283505
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122726
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283515
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 122727
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283518
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 56
Qty Limit Days: 28
ID: 122728
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283509
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122729
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283513
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122730
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283538
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28