CMS Formulary

Displaying 121011-121020 of 1611142 results.
ID: 121011
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121012
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121013
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085640
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121014
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085633
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121015
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085636
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121016
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197735
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121017
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 543546
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121018
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085644
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121019
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1014314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121020
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0