CMS Formulary

Displaying 119771-119780 of 1611142 results.
ID: 119771
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310295
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119772
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310297
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119773
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313992
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119774
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313993
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119775
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310293
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119776
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310294
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119777
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119778
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119779
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119780
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0