CMS Formulary

Displaying 119601-119610 of 1611142 results.
ID: 119601
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 746609
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119602
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 845512
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119603
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847734
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119604
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1002300
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 119605
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1012899
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119606
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1310138
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119607
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1310144
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119608
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1310147
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119609
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364114
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119610
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364118
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0