CMS Formulary

Displaying 119831-119840 of 1611142 results.
ID: 119831
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119832
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119833
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119834
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119835
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119836
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119837
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119838
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119839
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119840
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0