CMS Formulary

Displaying 119641-119650 of 1611142 results.
ID: 119641
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1873995
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119642
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1421456
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119643
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923054
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 119644
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801840
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119645
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923056
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 119646
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1923058
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 91
Qty Limit Days: 28
ID: 119647
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2002719
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 420
Qty Limit Days: 30
ID: 119648
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2058981
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119649
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1298099
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119650
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 545293
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0