CMS Formulary

Displaying 120761-120770 of 1611142 results.
ID: 120761
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1312627
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120762
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1988399
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120763
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1150836
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120764
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2118539
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120765
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120766
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120767
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120768
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120769
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120770
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0