CMS Formulary

Displaying 119501-119510 of 1611142 results.
ID: 119501
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1243014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119502
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1601394
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119503
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1601386
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119504
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1601390
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119505
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1987734
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119506
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058922
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119507
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2103175
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119508
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2103179
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119509
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284108
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119510
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2099952
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30