CMS Formulary

Displaying 124481-124490 of 1611142 results.
ID: 124481
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311207
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124482
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198239
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124483
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198238
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124484
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1922720
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124485
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905341
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124486
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 905347
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124487
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650143
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124488
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298910
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124489
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298816
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124490
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298906
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0