CMS Formulary

Displaying 121441-121450 of 1611142 results.
ID: 121441
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121442
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121443
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 430902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121444
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121445
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1369831
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121446
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1304985
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121447
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1811182
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121448
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716215
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121449
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716219
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121450
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1716223
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30