CMS Formulary

Displaying 120611-120620 of 1611142 results.
ID: 120611
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200371
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120612
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309314
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120613
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859044
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120614
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859048
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120615
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 317110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120616
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402698
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120617
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402696
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120618
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 402695
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120619
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 351249
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 120620
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 858625
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0