CMS Formulary

Displaying 124701-124710 of 1611142 results.
ID: 124701
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124702
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835564
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124703
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 835568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124704
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861156
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124705
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 998189
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124706
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 896758
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124707
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 896762
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124708
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 845515
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124709
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1119400
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124710
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 199369
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0