CMS Formulary

Displaying 39061-39070 of 1611142 results.
ID: 39061
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1799230
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39062
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925255
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39063
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1925257
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39064
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1598989
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39065
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1601660
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39066
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1992428
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39067
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 213282
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39068
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 213283
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39069
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 213284
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39070
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 859865
NDC:
Tier Level: 5
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0