CMS Formulary

Displaying 120171-120180 of 1611142 results.
ID: 120171
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 829762
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120172
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191234
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120173
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1724338
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120174
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120175
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120176
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120177
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120178
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120179
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120180
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659292
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0