CMS Formulary

Displaying 135211-135220 of 1611142 results.
ID: 135211
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 401953
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135212
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 401954
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135213
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 616698
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135214
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 616705
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135215
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312635
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135216
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198365
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135217
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 995666
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135218
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198145
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135219
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313215
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135220
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313217
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0