CMS Formulary

Displaying 119551-119560 of 1611142 results.
ID: 119551
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119552
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207346
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119553
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207361
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119554
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119555
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855871
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119556
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1855527
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119557
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921240
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119558
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921245
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119559
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1726846
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119560
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847745
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30