CMS Formulary

Displaying 120051-120060 of 1611142 results.
ID: 120051
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197963
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120052
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197318
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120053
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313354
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120054
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198274
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120055
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198275
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120056
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198270
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120057
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197960
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120058
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120059
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856422
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120060
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199903
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0