CMS Formulary

Displaying 135281-135290 of 1611142 results.
ID: 135281
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 993691
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135282
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903887
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135283
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903891
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135284
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 903884
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135285
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 242446
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135286
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 213291
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135287
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111339
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135288
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 860805
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135289
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1111343
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135290
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 284008
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0