CMS Formulary

Displaying 125291-125300 of 1611142 results.
ID: 125291
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125292
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125293
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125294
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125295
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125296
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125297
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125298
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125299
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125300
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0