CMS Formulary

Displaying 125391-125400 of 1611142 results.
ID: 125391
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310467
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125392
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 992395
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125393
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 860103
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125394
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310377
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125395
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 745462
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125396
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731541
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125397
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 836307
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125398
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731566
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125399
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731568
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125400
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 731571
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0