CMS Formulary

Displaying 124951-124960 of 1611142 results.
ID: 124951
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124952
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124953
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124954
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124955
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124956
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124957
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124958
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124959
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124960
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0