CMS Formulary

Displaying 122931-122940 of 1611142 results.
ID: 122931
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762836
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122932
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762839
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122933
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762843
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122934
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762875
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122935
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762849
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122936
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762852
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122937
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762859
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122938
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762868
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122939
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 762897
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 122940
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 260285
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0