CMS Formulary

Displaying 121191-121200 of 1611142 results.
ID: 121191
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 856377
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121192
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 308460
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121193
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121194
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 248656
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121195
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749780
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121196
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 204844
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121197
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198372
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121198
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198369
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121199
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121200
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1659803
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0