CMS Formulary

Displaying 122751-122760 of 1611142 results.
ID: 122751
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 483450
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122752
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 483438
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122753
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 483440
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122754
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 483444
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 122755
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2178403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 28
ID: 122756
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2178405
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28
ID: 122757
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2382990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 24
Qty Limit Days: 28
ID: 122758
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2178407
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 32
Qty Limit Days: 28
ID: 122759
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2178409
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 20
Qty Limit Days: 28
ID: 122760
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2382991
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 16
Qty Limit Days: 28