CMS Formulary

Displaying 125081-125090 of 1611142 results.
ID: 125081
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 207949
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125082
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966154
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125083
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966161
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125084
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966167
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125085
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125086
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125087
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966397
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125088
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125089
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966410
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125090
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966197
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0