CMS Formulary

Displaying 120451-120460 of 1611142 results.
ID: 120451
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120452
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311678
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120453
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085728
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120454
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1191315
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120455
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120456
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120457
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120458
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120459
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120460
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0