CMS Formulary

Displaying 126381-126390 of 1611142 results.
ID: 126381
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364498
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126382
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364490
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126383
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1364494
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126384
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1648772
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126385
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1491634
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126386
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 208560
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126387
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1992305
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126388
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 644304
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126389
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861659
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126390
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 861661
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0