CMS Formulary

Displaying 126871-126880 of 1611142 results.
ID: 126871
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1299903
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126872
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 2000695
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126873
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1299909
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126874
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1362706
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126875
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1362712
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126876
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1362720
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126877
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308865
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126878
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856448
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126879
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856457
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126880
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 856519
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0