CMS Formulary

Displaying 122781-122790 of 1611142 results.
ID: 122781
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801322
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 122782
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2262446
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122783
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123034
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122784
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2274390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 122785
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1799212
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 28
Qty Limit Days: 28
ID: 122786
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659183
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 122787
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659161
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 28
ID: 122788
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2472789
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 122789
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2478450
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122790
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2369403
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30