CMS Formulary

Displaying 119841-119850 of 1611142 results.
ID: 119841
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119842
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197405
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119843
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 103401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119844
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 242736
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119845
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 706546
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119846
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1670023
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119847
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1670016
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119848
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2107522
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119849
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616238
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119850
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897126
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 9
Qty Limit Days: 30