CMS Formulary

Displaying 122771-122780 of 1611142 results.
ID: 122771
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966182
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122772
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966187
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122773
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2104866
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122774
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966196
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122775
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122776
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122777
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122778
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848343
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122779
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665906
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 122780
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665900
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28