CMS Formulary

Displaying 119461-119470 of 1611142 results.
ID: 119461
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797907
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119462
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197730
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119463
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197731
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119464
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 756059
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119465
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311376
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 119466
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864761
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3600
Qty Limit Days: 30
ID: 119467
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864769
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1800
Qty Limit Days: 30
ID: 119468
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119469
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 315187
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119470
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0