CMS Formulary

Displaying 119411-119420 of 1611142 results.
ID: 119411
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404550
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119412
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 150840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119413
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 208949
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119414
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 202301
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119415
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000491
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119416
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000497
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119417
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000499
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119418
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000500
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119419
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000487
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119420
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 352228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0