CMS Formulary

Displaying 119901-119910 of 1611142 results.
ID: 119901
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995278
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119902
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995253
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119903
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198228
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119904
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 852913
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119905
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 993536
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119906
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 852877
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119907
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197979
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119908
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197978
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119909
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246306
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 119910
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1246290
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30