CMS Formulary

Displaying 120751-120760 of 1611142 results.
ID: 120751
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197433
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120752
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896766
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120753
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120754
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213263
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120755
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1012021
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120756
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 849506
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120757
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797863
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120758
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1099503
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120759
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 850309
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120760
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310015
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0