CMS Formulary

Displaying 125181-125190 of 1611142 results.
ID: 125181
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 805579
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 125182
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 901518
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 125183
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 830463
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 1
Qty Limit Days: 1
ID: 125184
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1601407
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 0
Qty Limit Days: 1
ID: 125185
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 809159
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125186
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 802652
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125187
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653225
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125188
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2182340
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125189
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2392142
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125190
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 261105
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0