CMS Formulary

Displaying 121051-121060 of 1611142 results.
ID: 121051
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197803
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121052
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861490
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121053
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 798133
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121054
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 884520
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 121055
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 755470
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121056
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 544452
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121057
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 597768
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121058
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 597770
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121059
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 597772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121060
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403975
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0