CMS Formulary

Displaying 120061-120070 of 1611142 results.
ID: 120061
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 998671
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120062
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 998675
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120063
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 998679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120064
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000048
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120065
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312593
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120066
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966220
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120067
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966221
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120068
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966222
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120069
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 966253
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120070
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 892246
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0