CMS Formulary

Displaying 119591-119600 of 1611142 results.
ID: 119591
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847741
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119592
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966191
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119593
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966201
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119594
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966205
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119595
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966251
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119596
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119597
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835892
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119598
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966185
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119599
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 212957
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119600
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2056897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0