CMS Formulary

Displaying 119761-119770 of 1611142 results.
ID: 119761
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1098678
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119762
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904467
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119763
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904475
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119764
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1490065
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119765
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199058
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119766
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 596843
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119767
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308868
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119768
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403879
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119769
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 476556
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119770
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197535
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0