CMS Formulary

Displaying 126411-126420 of 1611142 results.
ID: 126411
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1718936
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126412
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1652242
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126413
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1926332
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126414
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2380236
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126415
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1926331
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126416
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2380260
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126417
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311036
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126418
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2380256
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126419
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 847252
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126420
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 311026
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0