CMS Formulary

Displaying 119561-119570 of 1611142 results.
ID: 119561
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1872980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119562
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1747577
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119563
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1747579
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119564
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1747567
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119565
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1747580
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119566
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921017
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119567
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921010
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119568
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921468
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119569
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 152971
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 480
Qty Limit Days: 30
ID: 119570
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873087
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0