CMS Formulary

Displaying 124021-124030 of 1611142 results.
ID: 124021
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 628953
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124022
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 381056
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124023
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 206842
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124024
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 562251
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124025
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 617995
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124026
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198316
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124027
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 359296
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124028
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308212
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124029
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403810
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124030
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 403811
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0