CMS Formulary

Displaying 122811-122820 of 1611142 results.
ID: 122811
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1922765
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122812
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1922763
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122813
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105553
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122814
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 105590
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122815
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122816
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122817
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122818
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122819
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122820
Formulary ID: 00021049
Formulary Version: 16
Contract Year: 2021
RXCUI: 208560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0