CMS Formulary

Displaying 119391-119400 of 1611142 results.
ID: 119391
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402092
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119392
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119393
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861206
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119394
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904170
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119395
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854859
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119396
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1859000
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 18
Qty Limit Days: 30
ID: 119397
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119398
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119399
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119400
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0