CMS Formulary

Displaying 119421-119430 of 1611142 results.
ID: 119421
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1653579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 119422
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198148
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119423
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797833
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119424
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119425
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 393245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119426
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 885857
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119427
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860901
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 200
Qty Limit Days: 30
ID: 119428
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351265
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119429
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351266
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119430
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351267
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30