CMS Formulary

Displaying 120951-120960 of 1611142 results.
ID: 120951
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197702
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120952
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1049615
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 120953
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1736047
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120954
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1736050
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120955
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1736053
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120956
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1736044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120957
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120958
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1300272
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 28
ID: 120959
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312845
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120960
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312846
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0