CMS Formulary

Displaying 119991-120000 of 1611142 results.
ID: 119991
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847917
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 30
ID: 119992
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847913
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 2
Qty Limit Days: 30
ID: 119993
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1990869
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 119994
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206347
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119995
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1729511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119996
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085773
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119997
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1648999
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119998
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 486515
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 119999
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 730782
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120000
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1795470
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0