CMS Formulary

Displaying 124361-124370 of 1611142 results.
ID: 124361
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 862013
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124362
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 862019
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124363
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 862025
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124364
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 201388
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124365
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665102
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124366
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737578
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124367
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124368
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1659287
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124369
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 242800
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124370
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 312127
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0