CMS Formulary

Displaying 125881-125890 of 1611142 results.
ID: 125881
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1361226
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125882
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861363
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125883
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861365
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125884
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861356
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125885
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125886
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1737581
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125887
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 2049891
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125888
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 540617
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125889
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 404419
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 125890
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 213337
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0