CMS Formulary

Displaying 125621-125630 of 1611142 results.
ID: 125621
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722934
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125622
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 730781
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125623
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807632
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125624
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795609
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125625
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1807552
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125626
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861379
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125627
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861383
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125628
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1743549
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125629
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1795477
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125630
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 581531
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0