CMS Formulary

Displaying 125431-125440 of 1611142 results.
ID: 125431
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1000897
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125432
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1923428
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125433
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 831109
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125434
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 978573
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125435
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 308720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125436
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605071
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125437
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1605075
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125438
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314072
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125439
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 244967
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125440
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309680
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0