CMS Formulary

Displaying 123801-123810 of 1611142 results.
ID: 123801
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308714
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123802
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 755497
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123803
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992765
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123804
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 630208
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123805
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 245314
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123806
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 485968
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123807
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 991061
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123808
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000913
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123809
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198202
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123810
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1245443
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0