CMS Formulary

Displaying 126001-126010 of 1611142 results.
ID: 126001
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806683
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126002
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1806684
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126003
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1356074
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126004
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748832
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126005
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1874537
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126006
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722680
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126007
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1729516
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126008
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1486452
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126009
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1485332
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126010
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1543553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0