CMS Formulary

Displaying 134481-134490 of 1611142 results.
ID: 134481
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 863538
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134482
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665507
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134483
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1608276
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134484
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1608274
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134485
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1191299
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134486
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 240209
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134487
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1797883
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134488
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 318202
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134489
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 238600
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134490
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310465
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0