CMS Formulary

Displaying 121661-121670 of 1611142 results.
ID: 121661
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 854844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121662
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871465
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121663
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871463
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121664
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871461
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121665
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871459
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121666
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871469
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121667
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1871467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121668
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213360
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121669
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404449
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30
ID: 121670
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 700418
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30