CMS Formulary

Displaying 124931-124940 of 1611142 results.
ID: 124931
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124932
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124933
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124934
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124935
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124936
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198359
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124937
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 389242
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124938
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204119
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124939
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359020
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124940
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1358775
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0