CMS Formulary

Displaying 119821-119830 of 1611142 results.
ID: 119821
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198089
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119822
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119823
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119824
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1550940
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119825
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1655960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119826
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859824
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119827
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119828
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835840
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119829
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835809
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119830
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1649988
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0