CMS Formulary

Displaying 119301-119310 of 1611142 results.
ID: 119301
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 799830
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119302
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1045408
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119303
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1045404
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119304
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364441
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119305
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364447
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119306
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 607579
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119307
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119308
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119309
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 74
Qty Limit Days: 30
ID: 119310
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0