CMS Formulary

Displaying 119781-119790 of 1611142 results.
ID: 119781
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119782
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119783
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119784
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 828379
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119785
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119786
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119787
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119788
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856578
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119789
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856556
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119790
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1870230
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30