CMS Formulary

Displaying 122541-122550 of 1611142 results.
ID: 122541
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859040
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122542
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 859052
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122543
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 855642
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122544
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 312504
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122545
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 313291
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122546
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1245919
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122547
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1242786
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122548
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200329
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122549
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 864681
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122550
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 307731
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0