CMS Formulary

Displaying 119931-119940 of 1611142 results.
ID: 119931
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2047868
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 119932
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 608934
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119933
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 832718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119934
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801299
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119935
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 832731
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119936
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801295
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119937
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2123111
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119938
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119939
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197541
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119940
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 753478
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0