CMS Formulary

Displaying 121421-121430 of 1611142 results.
ID: 121421
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121422
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121423
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121424
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121425
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121426
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121427
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1650201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121428
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121429
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121430
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0