CMS Formulary

Displaying 119451-119460 of 1611142 results.
ID: 119451
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977427
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119452
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977434
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119453
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 977438
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119454
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1304979
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119455
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892625
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 119456
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311355
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119457
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197893
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119458
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313932
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119459
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309843
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119460
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1190568
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0