CMS Formulary

Displaying 119791-119800 of 1611142 results.
ID: 119791
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1870225
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 4
Qty Limit Days: 30
ID: 119792
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242831
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119793
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 239239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119794
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856605
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119795
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903857
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119796
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119797
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856660
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119798
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856652
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119799
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351133
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119800
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313979
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0