CMS Formulary

Displaying 121381-121390 of 1611142 results.
ID: 121381
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121382
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121383
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121384
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121385
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121386
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121387
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121388
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121389
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121390
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 749148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0