CMS Formulary

Displaying 119541-119550 of 1611142 results.
ID: 119541
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119542
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2105856
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119543
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2102472
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119544
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2168548
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119545
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058932
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119546
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1148506
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119547
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1148502
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119548
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2168540
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119549
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1313887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119550
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855673
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0