CMS Formulary

Displaying 119861-119870 of 1611142 results.
ID: 119861
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197589
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119862
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197391
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119863
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197392
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119864
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 597852
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119865
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 597850
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119866
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310273
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119867
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 284245
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119868
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835886
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119869
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866049
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119870
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896019
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30