CMS Formulary

Displaying 124881-124890 of 1611142 results.
ID: 124881
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 284593
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124882
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 284595
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124883
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 904158
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124884
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861495
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124885
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861448
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124886
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309370
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124887
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 103457
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124888
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124889
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310364
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124890
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 238920
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0