CMS Formulary

Displaying 119441-119450 of 1611142 results.
ID: 119441
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 477234
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119442
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199519
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119443
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197624
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119444
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437968
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119445
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437969
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119446
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897657
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1500
Qty Limit Days: 30
ID: 119447
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049604
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3900
Qty Limit Days: 30
ID: 119448
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1874559
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119449
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1874553
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119450
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 900575
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30