CMS Formulary

Displaying 120651-120660 of 1611142 results.
ID: 120651
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309079
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120652
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1438778
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120653
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440937
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120654
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440183
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120655
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1537209
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120656
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1487086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120657
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120658
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1539955
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120659
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1605086
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120660
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 904419
NDC:
Tier Level: 1
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30