CMS Formulary

Displaying 119481-119490 of 1611142 results.
ID: 119481
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119482
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119483
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119484
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119485
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197931
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119486
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312617
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119487
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198144
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119488
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198146
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119489
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213272
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119490
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206792
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0