CMS Formulary

Displaying 119711-119720 of 1611142 results.
ID: 119711
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 598025
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119712
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119713
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119714
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617296
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119715
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 636664
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119716
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 608328
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119717
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1148141
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 119718
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861960
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119719
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1090996
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119720
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197595
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0