CMS Formulary

Displaying 119941-119950 of 1611142 results.
ID: 119941
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 753479
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119942
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1428933
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119943
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091828
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119944
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351173
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119945
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351174
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119946
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351175
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119947
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 794639
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119948
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 616578
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119949
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 999965
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119950
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801417
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0