CMS Formulary

Displaying 121141-121150 of 1611142 results.
ID: 121141
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121142
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121143
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121144
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121145
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861164
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121146
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 861171
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121147
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 645037
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121148
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000064
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121149
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577154
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121150
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198140
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0