CMS Formulary

Displaying 135871-135880 of 1611142 results.
ID: 135871
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 1653221
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135872
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311288
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135873
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 311289
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135874
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 387003
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135875
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 807832
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135876
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 846378
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135877
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309112
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135878
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 309114
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135879
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 828373
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 135880
Formulary ID: 00021056
Formulary Version: 15
Contract Year: 2021
RXCUI: 310274
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0