CMS Formulary

Displaying 122761-122770 of 1611142 results.
ID: 122761
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2382993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 8
Qty Limit Days: 28
ID: 122762
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272630
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 122763
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272622
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 122764
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272636
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 122765
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2272624
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 122766
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966153
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122767
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966160
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122768
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966166
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122769
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966173
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122770
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966177
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0