CMS Formulary

Displaying 119971-119980 of 1611142 results.
ID: 119971
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2047639
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119972
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2053927
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 119973
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721571
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119974
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1721583
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119975
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1989109
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119976
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2205634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119977
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1790644
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 119978
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2387331
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 10
Qty Limit Days: 30
ID: 119979
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858044
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 119980
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858040
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30