CMS Formulary

Displaying 121041-121050 of 1611142 results.
ID: 121041
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197574
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 100
Qty Limit Days: 30
ID: 121042
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 358917
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121043
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309333
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121044
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 388517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121045
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198245
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121046
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1597076
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121047
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992441
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121048
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992454
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121049
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861434
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121050
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197785
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0