CMS Formulary

Displaying 121171-121180 of 1611142 results.
ID: 121171
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 207364
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121172
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1486687
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121173
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121174
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197726
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121175
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1653217
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121176
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860225
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121177
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111018
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121178
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 212381
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121179
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1430383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121180
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1440185
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0