CMS Formulary

Displaying 122731-122740 of 1611142 results.
ID: 122731
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283536
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 122732
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2283540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 122733
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311944
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122734
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1249631
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122735
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058520
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122736
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058525
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122737
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 208083
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122738
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2275613
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122739
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272118
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122740
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272122
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30