CMS Formulary

Displaying 125501-125510 of 1611142 results.
ID: 125501
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1801294
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125502
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1044591
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125503
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311192
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125504
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311197
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125505
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311196
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125506
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 854868
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125507
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897584
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125508
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897590
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125509
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 897596
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125510
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 317769
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0