CMS Formulary

Displaying 122631-122640 of 1611142 results.
ID: 122631
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198007
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122632
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 198008
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122633
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 200311
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122634
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 310431
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122635
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1731020
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122636
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 403930
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122637
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1944656
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122638
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197843
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122639
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197844
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122640
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 197845
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0