CMS Formulary

Displaying 120371-120380 of 1611142 results.
ID: 120371
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198077
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120372
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198078
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120373
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198075
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120374
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313472
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 240
Qty Limit Days: 30
ID: 120375
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198153
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120376
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905269
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120377
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905283
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120378
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198152
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120379
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312615
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120380
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197365
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0