CMS Formulary

Displaying 119491-119500 of 1611142 results.
ID: 119491
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207850
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119492
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207100
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119493
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 208821
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119494
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011080
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119495
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119496
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213320
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119497
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119498
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307630
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119499
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307635
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119500
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243010
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30