CMS Formulary

Displaying 122741-122750 of 1611142 results.
ID: 122741
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272126
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122742
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2394947
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122743
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2199304
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122744
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2199308
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122745
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2199312
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122746
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2199316
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122747
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2099323
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122748
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206883
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122749
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2473107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122750
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206902
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0