CMS Formulary

Displaying 124991-125000 of 1611142 results.
ID: 124991
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124992
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124993
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124994
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124995
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124996
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124997
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091635
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124998
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091638
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 124999
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091623
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125000
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543069
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 152
Qty Limit Days: 30