CMS Formulary

Displaying 38901-38910 of 1611142 results.
ID: 38901
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369737
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38902
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1722676
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38903
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1369770
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38904
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941470
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38905
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941476
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38906
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1941473
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38907
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 197698
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38908
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 856783
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38909
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607796
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 38910
Formulary ID: 00021011
Formulary Version: 14
Contract Year: 2021
RXCUI: 1607792
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0