CMS Formulary

Displaying 119581-119590 of 1611142 results.
ID: 119581
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966271
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119582
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 727705
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119583
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1655728
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119584
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 825170
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119585
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119586
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966158
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119587
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966247
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119588
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966171
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119589
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966282
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119590
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966250
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0