CMS Formulary

Displaying 120191-120200 of 1611142 results.
ID: 120191
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309092
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120192
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1665005
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120193
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120194
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 727575
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120195
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1653470
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120196
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1086776
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120197
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1086780
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120198
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1086786
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120199
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307415
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 120200
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1307421
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30