CMS Formulary

Displaying 134841-134850 of 1611142 results.
ID: 134841
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134842
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 855671
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134843
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311679
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134844
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 105583
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134845
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 199378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134846
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402505
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134847
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 402506
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134848
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1313885
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134849
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 577237
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134850
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310285
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0