CMS Formulary

Displaying 126121-126130 of 1611142 results.
ID: 126121
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 311877
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126122
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749784
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126123
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 644088
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126124
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 866905
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126125
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1041518
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126126
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 751553
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126127
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1603861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126128
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1251336
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126129
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 749157
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126130
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 748798
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0