CMS Formulary

Displaying 121371-121380 of 1611142 results.
ID: 121371
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121372
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121373
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121374
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121375
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751884
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121376
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1011081
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121377
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1112687
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121378
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748879
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121379
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121380
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0