CMS Formulary

Displaying 126761-126770 of 1611142 results.
ID: 126761
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1251596
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126762
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 207035
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126763
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 261101
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126764
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 847232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126765
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 285018
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126766
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866094
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126767
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 866083
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126768
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 211817
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126769
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1801283
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126770
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 978006
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0