CMS Formulary

Displaying 125721-125730 of 1611142 results.
ID: 125721
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213439
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125722
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 979115
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125723
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244062
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125724
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1244064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125725
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 637216
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125726
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125727
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673278
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125728
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1673280
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125729
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1925264
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125730
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049343
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0