CMS Formulary

Displaying 121761-121770 of 1611142 results.
ID: 121761
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121762
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121763
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121764
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121765
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312055
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121766
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1085745
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121767
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992432
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121768
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1000054
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121769
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831215
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 121770
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 831252
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0