CMS Formulary

Displaying 119701-119710 of 1611142 results.
ID: 119701
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855296
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119702
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855332
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119703
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855344
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119704
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242461
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119705
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242462
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119706
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119707
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119708
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311668
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119709
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119710
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308177
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0