CMS Formulary

Displaying 119351-119360 of 1611142 results.
ID: 119351
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1441740
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119352
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835721
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119353
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119354
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1046920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119355
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404457
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119356
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404458
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119357
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404459
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119358
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1549456
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119359
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1549454
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119360
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205562
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0