CMS Formulary

Displaying 122801-122810 of 1611142 results.
ID: 122801
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284514
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122802
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1809436
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122803
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 836358
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122804
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 349590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122805
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311286
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122806
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242754
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122807
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191250
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122808
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207373
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122809
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245268
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 122810
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 885209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0