CMS Formulary

Displaying 120301-120310 of 1611142 results.
ID: 120301
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751885
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120302
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 753481
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120303
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 762333
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120304
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 751890
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120305
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358780
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120306
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1358765
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120307
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359030
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120308
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120309
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1359135
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120310
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1095362
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0