CMS Formulary

Displaying 39871-39880 of 1611142 results.
ID: 39871
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1658637
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39872
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 307718
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39873
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 307719
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39874
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 831430
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39875
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807516
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39876
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1665210
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39877
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 239209
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39878
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1807518
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39879
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 1860139
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 39880
Formulary ID: 00021014
Formulary Version: 14
Contract Year: 2021
RXCUI: 800192
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0