CMS Formulary

Displaying 119371-119380 of 1611142 results.
ID: 119371
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119372
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119373
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119374
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 260285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119375
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205826
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119376
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011987
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119377
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856935
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119378
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1009341
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119379
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000089
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119380
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190955
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30