CMS Formulary

Displaying 125001-125010 of 1611142 results.
ID: 125001
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1010878
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125002
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1085741
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125003
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191302
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125004
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310152
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125005
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1190357
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125006
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2180999
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125007
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1716268
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125008
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1921598
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125009
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 430902
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125010
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 828348
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0