CMS Formulary

Displaying 121471-121480 of 1611142 results.
ID: 121471
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121472
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309309
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121473
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197512
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121474
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121475
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373335
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121476
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1373337
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121477
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312084
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121478
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198051
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121479
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312077
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121480
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313412
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0