CMS Formulary

Displaying 134861-134870 of 1611142 results.
ID: 134861
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 359385
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134862
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 834768
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134863
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748859
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134864
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359032
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134865
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1359027
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134866
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 751875
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134867
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903456
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134868
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903697
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134869
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903703
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134870
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313195
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0