CMS Formulary

Displaying 119431-119440 of 1611142 results.
ID: 119431
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119432
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905168
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119433
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892589
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3000
Qty Limit Days: 30
ID: 119434
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 894780
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 119435
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997170
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119436
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997287
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119437
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 997296
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119438
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310792
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119439
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310793
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119440
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835589
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0