CMS Formulary

Displaying 120351-120360 of 1611142 results.
ID: 120351
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120352
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197502
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120353
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 863559
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 1080
Qty Limit Days: 30
ID: 120354
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897612
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120355
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897618
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120356
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897624
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120357
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 897630
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120358
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312025
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120359
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198041
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120360
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 582926
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0