CMS Formulary

Displaying 119511-119520 of 1611142 results.
ID: 119511
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105860
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119512
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 637188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119513
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 795735
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119514
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 637190
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119515
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 795737
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119516
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284104
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119517
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1741049
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119518
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2273115
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119519
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616283
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119520
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2284106
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30