CMS Formulary

Displaying 125101-125110 of 1611142 results.
ID: 125101
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 730046
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125102
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731231
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125103
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731235
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125104
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731241
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125105
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731245
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125106
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605172
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125107
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 352262
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125108
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731229
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125109
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 727542
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125110
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 993456
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 180