CMS Formulary

Displaying 119651-119660 of 1611142 results.
ID: 119651
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207029
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119652
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 665022
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 600
Qty Limit Days: 30
ID: 119653
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2196592
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 119654
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1720881
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119655
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119656
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119657
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246313
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 119658
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246310
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 13
Qty Limit Days: 30
ID: 119659
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119660
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0