CMS Formulary

Displaying 125091-125100 of 1611142 results.
ID: 125091
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966399
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125092
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125093
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 966214
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125094
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 352044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125095
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 352045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125096
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 352046
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125097
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 352047
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125098
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1654955
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125099
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731227
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125100
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731250
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0