CMS Formulary

Displaying 125441-125450 of 1611142 results.
ID: 125441
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309679
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125442
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1376336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125443
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 204874
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125444
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313415
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125445
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1006120
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125446
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197310
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125447
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 309045
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125448
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197449
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125449
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125450
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0