CMS Formulary

Displaying 119671-119680 of 1611142 results.
ID: 119671
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831054
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119672
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197724
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119673
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197381
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119674
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197379
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119675
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197603
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119676
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904458
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119677
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197380
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119678
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198045
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119679
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317136
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119680
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0