CMS Formulary

Displaying 120021-120030 of 1611142 results.
ID: 120021
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1860463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120022
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1860239
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120023
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120024
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 615107
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120025
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 615111
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120026
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 847626
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120027
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312128
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120028
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 240637
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120029
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 801405
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120030
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 866924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0