CMS Formulary

Displaying 120461-120470 of 1611142 results.
ID: 120461
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120462
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120463
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120464
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120465
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120466
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 899461
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120467
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 899485
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120468
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1101926
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120469
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 899495
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120470
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1101932
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0