CMS Formulary

Displaying 121361-121370 of 1611142 results.
ID: 121361
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121362
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121363
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121364
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121365
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121366
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121367
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121368
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121369
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121370
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0