CMS Formulary

Displaying 135001-135010 of 1611142 results.
ID: 135001
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966178
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135002
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966397
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135003
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966188
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135004
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966410
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135005
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966197
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135006
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966399
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135007
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966208
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135008
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 966214
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135009
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 352044
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135010
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 352045
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0