CMS Formulary

Displaying 121771-121780 of 1611142 results.
ID: 121771
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831285
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121772
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312301
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121773
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121774
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197685
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121775
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859186
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121776
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121777
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197626
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121778
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197627
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121779
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197628
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121780
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 199390
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0