CMS Formulary

Displaying 134871-134880 of 1611142 results.
ID: 134871
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198240
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134872
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 749148
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134873
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748865
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134874
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 749848
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134875
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 753544
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134876
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 750244
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134877
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2468058
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134878
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2471314
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134879
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748962
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134880
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 831533
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0