CMS Formulary

Displaying 119871-119880 of 1611142 results.
ID: 119871
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896027
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119872
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896023
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119873
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213484
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119874
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 759473
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119875
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896185
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119876
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896212
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119877
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896229
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119878
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896237
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 119879
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896245
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30
ID: 119880
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896273
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 12
Qty Limit Days: 30