CMS Formulary

Displaying 135381-135390 of 1611142 results.
ID: 135381
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 212039
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135382
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 212232
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135383
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 212373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135384
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1946772
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135385
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 198181
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135386
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 251322
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135387
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242611
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135388
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242613
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135389
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1663728
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135390
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1242615
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0