CMS Formulary

Displaying 126511-126520 of 1611142 results.
ID: 126511
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1604544
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126512
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2002420
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126513
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1797880
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126514
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1113046
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126515
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863836
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126516
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863841
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126517
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 863829
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126518
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1373327
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126519
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 207370
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126520
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 706467
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0