CMS Formulary

Displaying 125531-125540 of 1611142 results.
ID: 125531
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 849389
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125532
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313407
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125533
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 313408
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125534
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1536490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125535
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 310878
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125536
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311982
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125537
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 104884
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125538
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861430
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125539
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125540
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197940
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0