CMS Formulary

Displaying 122461-122470 of 1611142 results.
ID: 122461
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 205315
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122462
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122463
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313585
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122464
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992438
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122465
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 992447
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122466
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310672
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122467
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 314035
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122468
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197754
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122469
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 686924
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122470
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200032
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0