CMS Formulary

Displaying 119811-119820 of 1611142 results.
ID: 119811
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 810002
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119812
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 809990
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119813
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 809994
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119814
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 809998
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119815
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995156
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1200
Qty Limit Days: 30
ID: 119816
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308963
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119817
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317173
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119818
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308964
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 270
Qty Limit Days: 30
ID: 119819
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197604
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119820
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197606
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0