CMS Formulary

Displaying 125451-125460 of 1611142 results.
ID: 125451
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125452
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125453
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125454
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125455
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125456
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125457
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125458
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125459
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 763457
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125460
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1667666
NDC:
Tier Level: 4
Qty Limit?: 0
Qty Limit Amt: 30
Qty Limit Days: 30