CMS Formulary

Displaying 124331-124340 of 1611142 results.
ID: 124331
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 864650
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124332
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308511
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124333
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1375922
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124334
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 863042
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124335
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204423
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124336
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310687
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124337
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314165
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124338
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 226343
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124339
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191013
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124340
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308493
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0