CMS Formulary

Displaying 125321-125330 of 1611142 results.
ID: 125321
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 317128
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125322
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309337
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125323
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1596023
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125324
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197388
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125325
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197980
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125326
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 544455
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125327
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 617322
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125328
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 863599
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125329
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 995241
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125330
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309686
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0