CMS Formulary

Displaying 119271-119280 of 1611142 results.
ID: 119271
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946840
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119272
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946844
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119273
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2180671
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119274
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1946848
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119275
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 865098
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119276
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 752388
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119277
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 731281
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119278
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652646
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119279
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119280
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0