CMS Formulary

Displaying 122381-122390 of 1611142 results.
ID: 122381
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309098
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122382
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835572
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122383
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835591
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122384
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 835577
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122385
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312940
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122386
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309080
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122387
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309081
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122388
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197452
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122389
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197453
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122390
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 309110
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0