CMS Formulary

Displaying 39221-39230 of 1611142 results.
ID: 39221
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 343033
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39222
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197579
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39223
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197580
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39224
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197581
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39225
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197582
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39226
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197583
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39227
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 310429
NDC:
Tier Level: 1
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39228
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197860
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39229
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197861
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39230
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 197862
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0