CMS Formulary

Displaying 121161-121170 of 1611142 results.
ID: 121161
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403825
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121162
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121163
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121164
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 250820
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 121165
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858751
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121166
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858733
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121167
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 848943
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121168
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1801279
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121169
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121170
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403840
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0