CMS Formulary

Displaying 135221-135230 of 1611142 results.
ID: 135221
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313219
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135222
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 260376
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135223
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 328161
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135224
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197971
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135225
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 861064
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135226
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197787
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135227
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197782
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135228
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 197783
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135229
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 313142
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135230
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 312347
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0