CMS Formulary

Displaying 119961-119970 of 1611142 results.
ID: 119961
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207273
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119962
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1437709
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119963
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2001321
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119964
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091843
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119965
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402091
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119966
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1986819
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 119967
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2289424
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 119968
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2289428
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119969
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1942485
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30
ID: 119970
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1942489
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30