CMS Formulary

Displaying 126921-126930 of 1611142 results.
ID: 126921
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 308189
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126922
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313797
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126923
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 239191
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126924
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665052
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126925
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665444
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126926
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 1665449
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126927
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 313920
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126928
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 106258
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126929
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 203105
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 126930
Formulary ID: 00021052
Formulary Version: 17
Contract Year: 2021
RXCUI: 197409
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0