CMS Formulary

Displaying 119911-119920 of 1611142 results.
ID: 119911
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1666334
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119912
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1116639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119913
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119914
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 991233
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119915
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308047
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119916
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308048
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119917
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197321
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119918
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197322
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 150
Qty Limit Days: 30
ID: 119919
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197444
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119920
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197445
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0