CMS Formulary

Displaying 134901-134910 of 1611142 results.
ID: 134901
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111110
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134902
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 2279847
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134903
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1001690
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134904
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 905394
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134905
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 404539
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134906
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1426600
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134907
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1650201
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134908
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 748977
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134909
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091632
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134910
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1091629
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0