CMS Formulary

Displaying 134991-135000 of 1611142 results.
ID: 134991
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1665517
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134992
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1668238
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134993
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1722939
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134994
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861360
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134995
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1734683
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134996
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 207949
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134997
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966154
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134998
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966161
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 134999
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966167
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135000
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966401
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0