CMS Formulary

Displaying 119521-119530 of 1611142 results.
ID: 119521
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616287
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119522
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1541928
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119523
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 702296
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119524
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616292
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119525
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1357547
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119526
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2048568
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119527
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102440
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119528
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2478437
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 300
Qty Limit Days: 30
ID: 119529
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102456
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119530
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2099956
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30