CMS Formulary

Displaying 120431-120440 of 1611142 results.
ID: 120431
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199167
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120432
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199164
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120433
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763181
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120434
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763179
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120435
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763185
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120436
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 763183
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120437
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861424
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120438
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1047040
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120439
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1047041
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120440
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1727569
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0