CMS Formulary

Displaying 121791-121800 of 1611142 results.
ID: 121791
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121792
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121793
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121794
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121795
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121796
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313919
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 3
Qty Limit Days: 28
ID: 121797
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121798
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797867
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121799
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1797847
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121800
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 860107
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0