CMS Formulary

Displaying 119731-119740 of 1611142 results.
ID: 119731
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 834046
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119732
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 834040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119733
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197536
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119734
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 429212
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119735
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309374
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119736
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119737
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995218
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119738
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299896
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119739
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866090
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119740
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 643066
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30